Application for 4 Week Intensive with Dr. Mary Susan McConnell

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* 1. What is your full name?

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* 2. What do you go by?

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* 3. Tell us a little bit about your journey / life / family - whatever you feel like sharing.

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* 4. Why are you interested in being a part of this 4 week intensive with Mary Susan?

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* 5. If you are chosen, do you understand you will be immediately invoiced for the full payment of $387 USD?

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* 6. If so, what is a PayPal address that can be invoiced? (answer with N/A for this question if you don't have PayPal)

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* 7. If you don't have PayPal, what is a good email for an invoice to be sent? (If you do have PayPal skip this question or write N/A)

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* 8. Thank you for your interest! If the spots have filled up you will be put on a waiting list. You will be contacted either way. Please fill out the contact info below and we will be in touch.

All my love! Mary Susan

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