MindBodySpirit Practitioner Certification Application

Name*
FirstLast
Address*
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Email*
Phone*
Birthday and Year
Which Class Are You Interetsed In?*
Why are you drawn to this class? *
What are your intentions in taking this class? *
Are you willing to attend every class? *
Are you willing to do homework and practice outside of class if necessary? *
What classes have you taken to prepare for this type of class? *
What are you hoping to take away from this class?*
How do you see this class affecting your daily life, whether as a profession or for personal growth?*
Are you ready to push yourself, and why? *
Give me a little background about your spiritual beliefs and history? *
What holds you back or limits you at this time, if anything?*
Give me four words that you would use to describe you! *
What are your 3 favorite things to do with your spare time? *

Schedule Book Tour Dates

We have SO MANY DATES ... that you have to click here to see them all.

2012
• February 17 - Santa Rosa, California
• February 19 - Sacramento, California
• February 23 - Tempe, Arizona
• February 25 - Scottsdale, Arizona
• March 8 - Austin, Texas
• March 9 - San Antonio, Texas
• March 10- Austin, Texas
• March 11 - Helotes, Texas
• March 13 - Laredo, Texas
• March 16 - San Antonio, Texas
• March 17 - Austin, Texas
• March 18 - Houston, Texas