Your Name (required) Phone Number Best Time to call Gender?* MaleFemaleOther If you selected other as your gender then please put your gender identity here. What is your email address? What is your address? Skype Name (If available) Website (If available) Date of Birth If you know them, please share your astrological sun, moon, and rising signs and your Chinese animal year. How did you find out about the Mystery School and/or the Vibrational Healing Program? If it was a Web search: What key words did you use? What attracted you about the website or the program? If it started by reading my book(s), which book(s) did you read, and where did you find it? What did you like about it: Have you read any of my books? Which ones? What do you want most to change or to evolve about yourself? Are you interested in becoming a Certified Vibrational Energy Coach? ____ Why? Would you be able to come to Hawaii for 2 weeks (please see the Calendar for the relevant dates)? This is a requirement for full Certification. Would you be able to pay the nonrefundable deposits for food and lodging on the dates indicated? Are you available on Sundays or/and Wednedays from 8-10 pm EST (for Phase 1) YesNoMaybe Are you available on Sundays from 2-4 pm EST (for Phase 2). YesNoMaybe In addition to a 2-3 hour class once a week, would you be available for two hours or more of homework on some weeks (this does not always happen)? YesNoMaybe Have you read or listened to or watched any of the books or CDs or DVDs on the Recommended List? If so, which ones? Level of Formal Education (just curious): What kind of work do you do—or are you retired, or a student, or primarily a parent? Do you consider yourself an Indigo Child or Crystal Child or a member of the Third Wave of Consciousness, anything else that you care to mention? Do you have the funds to pay for the Program? YesNoMaybe Do you have any special training, workshops and apprenticeships in healing and related areas? YesNo What experience have you had in healing other people? (any kind) Are you married or in a committed relationship? YesNo Do you live together? YesNo Please say a few words about your current relationship. If you have been married previously, and if you care to, please say a few words about ex-partners that made an impact on your life. Do you have children? YesNo If so, what ages, sexes? Do they live with you? How do you feel about them? How do you feel about your parents? (Whether they are alive or not.) Do you have siblings? YesNo If so, how do you feel about them? What is your nationality? (Just curious.) Were you raised with a particular religion? If so, what was it? Are you a member of a particular religion now? What are your goals for yourself in the next year—personally and professionally? Do you feel that the Mystery School and/or the Vibrational Healing Program could assist you in accomplishing your goals? Please elaborate. Name and tell about one person who has had a profound influence on you, and why. Do you love yourself? Please elaborate. Do you currently work with energy? YesNo Do you practice any form of Vibrational Healing for yourself or others? YesNo Are you currently in counseling or therapy or under the care of a psychiatrist for any condition? Please explain. If you are taking drugs (of any kind) for depression or mental conditions or physical conditions, please elaborate. Do you use recreational drugs or alcohol or cigarettes or caffeine frequently? Please elaborate. Are you currently under the care of a physician for any chronic conditions? Please explain. What would you like me to know about you? Ask me a good question. OPTIONAL QUESTIONS If you would like to go deeper, feel free to answer any of these questions: What is the hardest thing you've ever worked for? What do you value most in life? Tell about one of your happiest moments. Do you have any kind of spiritual practice? Please describe. What do you do when you are under a lot of stress? What do you do when you feel angry? Do you see, hear, or feel energies or have experiences that are unusual? Please elaborate. What is your nationality or cultural or religious background? Is there anything you would like to share about this? If you join the Mystery School and you take the Vibrational Healing Program, what would be your best-case scenario about the changes that would occur in your personal and professional life? *If you have a non-traditional sexual expression (gay, lesbian, transexual), please feel free to write or talk about it. Note: People of all sexual persuasions, races and colors are welcome in the program and will certainly not be discriminated against. If there is anything that is a source of discomfort in your life, please know that I am committed to creating an atmosphere of unconditional love and acceptance, and I want you to feel free to write or talk about these issues when the time feels right. Anyone who attends these workshops is asked to have absolute commitment to preserving confidentiality about any personal information that is shared during the classes. You will be asked to leave your judgments behind. If this is difficult for you to do, that’s okay, as long as you see it as a challenge and are willing to be honest and work on changing your attitude (toward yourself and others). PLEASE ATTACH A HEADSHOT OF YOURSELF Why a photo? Photos are worth a thousand words--especially if you're psychic! Don't worry - you will not be discriminated against for anything related to your personal appearance. Thanks for taking the time to do this, JOY- If you would like to leave any comments, please do so in the box below.
