Homestudy Course Application

Homestudy Course Application
(This information is kept completely confidential.)

Personal Info:	Name:
	Address:
	City: State:
	Zip: Country:
	Phone: (we will NOT call you unless it's dire...)

E-mail Address (Please type carefully):

Date of Birth: MM/DD/YY

Surface gender:
Male Female {not to be confused with inner or spiritual gender! }

Marital Status:
Single Married Divorced Too long a story for this space
Number of Children: Boy(s) Girl(s)
Partner's Name:

Please check the course you would like to receive:
Psychic Counselors Course
(Courses coming soon: Dream Interpretation Homestudy Course, and How To Become A Professional Tarot Reader)

Half price discount is also granted for members of the same household. The first person pays full tuition and the second person pays half price if both apply at the same time.

Please enter your name exactly as you want it to appear on your Training Certificate.

Do you pledge to use your Counselor/Reader Status for the Service of Humanity?

Member Profile

The following questions are somewhat optional, but we encourage you to answer them because they help us build a picture of you and what has made you the person you are. Souls appear and re-appear in "families" or "soul groups". They often follow family bloodlines, you ARE your ancestors. Past lives are sometimes hard to believe in, but genetic memory is very real. The things you are drawn to in life, flashbacks, and deja vu are your genetic memory nagging you. We can better help you get where you're going if we have a complete profile of you and your ancestral background.

What religion were you raised on?
Do you still practice its ways?	Fully Somewhat	Seldom Never
How does your immediate family feel about your chosen spiritual path? Opposition? Approval?

Please check any of the following areas you have studied or "dabbled" in: {You can skip this section if you have already filled in these questions on the Ordained Minister's Application.}

More about you	Your occupation,
	Special Skills,
	Hobbies, etc.?

How did you hear about us? New Age Journal Link from TheDreamZone.com

A friend told/emailed me Discussion List Link from any other website

Search Engine Query Heard Dr. Katia on a Radio Show Any other source: (please explain)

Payment information:

If you are petitioning for an Ordination at this time, the Ordination fee is reduced to $75.

Please check the box next to the items you are ordering.

Check this box only if you want Rush shipping. Cost varies, depending on where you are.

Payment Methods

Visa
MasterCard
Discover (you will be contacted by email for your card number)
Paypal

Please review your application above and if you are happy with it, click on the button below. (Print this now before you click "Send" if you want to keep a copy of this application for your records)

Homestudy Course Application (This information is kept completely confidential.)

Homestudy Course Application
(This information is kept completely confidential.)