Selomon Intake Form

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Selomon Intake Form

Thank you for your interest in working with Selomon. Please fill out the form below to help him understand your needs and how to best support your creative project.

Email *

Name *

Email/Phone Number
What way do you prefer to be contacted? *

What Type of Assistance Are You Looking For? *

Meditation/Reiki/Sound Healing One-on-One ($50/30 Mins or $90/1hr)

Video/Audio Editing ($150 for 2 hours of basic editing)

Story Editing/Books/Self-Publishing ($200 for basic editing up to 50 pages)

Creative Companionship (Assistance with Any Kind of Creative Project)

Group Meditations/Workshops/Courses and Other Events

Other:

Required

Are you able to pay for these services based on suggested pricing? Will you need financial assistance? *

I can buy based on suggested prices

I will need financial assistance

Other:

What is your goal or vision for the project? What are you hoping to accomplish by working with Selomon? *

When would you like to start?

YYYY

When are you aiming to complete the project or finishing your work with Selomon?

YYYY

Do you consent to be contacted by Selomon regarding this form? *

Yes

Other:

Submit

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