Application •

APPLICATION FORM

Whether you seek to feel vibrantly alive and at home in your own body, dissolve obstacles to intimacy, or plumb the depths of human consciousness, I look forward to connecting with you. Please answer the following questions in the form below. I’ll be in touch personally and also send you newsletter updates.

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First Name*

Last Name*

Best phone#*

Email*

City*

State

Country

Please write in the title and dates of the offering(s) that interest you.

Tell me about yourself. I’ve love to learn a little about your current life, your spiritual journey, your background with the Realization Process, and how you learned about me.

The nature of this work sometimes puts us in touch with challenging memories and emotions. Is there anything in your personal history that might be helpful for me to know?

Please add anything else that you feel is relevant.

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