Luminous Listener Membership Application
To apply for a membership, please complete all required questions.
Name
*
First Name
Last Name
Pronouns
E-mail
*
example@example.com
Phone Number
-
Area Code
Phone Number
City
*
Country
*
What is your age range?
*
13 - 17
18 - 25
26 - 35
36 - 45
46 - 55
56 - 65
65+
I prefer not to answer
If you prefer not to answer, please set the option "I prefer not to answer."
Postal Code
How did you find us?
*
Instagram
Facebook
YouTube
EventBrite
Friend
Family
Podcast
Blog
Search Engine (Google, Yahoo, etc.)
Please mark all of the event types you have attended from us
*
Poetry Night
Trivia Night
Galactic Study Session (Group A or B)
None
Other
Briefly explain why you are interested becoming a Luminous Listener.
*
List any topics or subjects you have previously studied that are related to cosmic consciousness, quantum science, cosmology, metaphysics, nutrition, energy healing or other related topic.
*
Would you to be added to the private online Luminous Listener Community Forum?
*
Yes
No
Would you to be added to the private online Galactic Study Community Forum?
*
Yes
No
By submitting this application, you agree to receive notifications from Quantum Nest LLC.
*
I agree
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