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Potential Student Form
Note: Filling out this form does NOT commit you to the course. It is to understand where you are in your learning process and for student and teacher compatibility.
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* Indicates required question
Email
*
Your email
Name
*
Your answer
Phone number
Your answer
Preferred method of contact
*
Text
Phone call
Email
What would you like to get out of our coaching?
*
Your answer
How committed are you to making positive changes in your life?
*
Your answer
Do you have an open mind to see things from a different perspective?
*
Yes
No
Maybe
Other:
Are you open to trying different approaches to heal and balance your energy? *note we will never have you do something you are uncomfortable with
*
Your answer
This will be challenging to your human ego. Are you willing to step out your own way?
*
Yes
No
Other:
Can you be honest with yourself to see where you might need work?
*
Yes
No
Other:
Are you familiar with the Chakra system?
*
Your answer
Do you meditate?
*
Yes
No
Sometimes
I tried but don't anymore- I need more guidance
Do you spend quality time with nature?
*
Yes
No
Do you use healing stones to aid your energy vibration?
*
Yes
No
Maybe
Other:
Do you use divination tools such as tarot cards to aid you in finding answers to your questions?
*
Yes
No
How do you or will you use your gifts to help others?
Your answer
Are you familiar with the Clair senses?
*
Yes
No
If so, do you know your dominant sense?
*
Your answer
Thank you for taking the time to fill out this survey. I will be contacting you shortly to discuss your answers and the class with you! ~ Mary Bee Contact Info: 850-665-0550 |
spiritsoperator@gmail.com
| Spiritsoperator.com
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