Bridge to Mastery
Application Form
Name
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First Name
Last Name
Email
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example@example.com
Work Phone Number
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Please enter a valid phone number.
Cell Phone Number
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Address
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Street Address
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City
State / Province
Postal / Zip Code
Profession
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In which BTMI program you are interested in?
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Please Select
Quantum Healing Mastercourse
Microcurrent & Vibrational Medicine
Quantum Healing And Coaching Program
Quantum Healing Certification Program
Why do you want to enroll in this Bridge to Mastery program?
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Briefly describe your previous experiences with healing energy and meditation
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What specific skills or abilities are you most interested in developing through BTMI programs?
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What is your vision for your life and work moving forward?
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What do you believe are your major blockages or limitations at fulfilling your vision?
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What support do you need in fulfilling your potential as a healer or practitioner?
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What realistic time commitment are you willing to make for daily meditative or self-healing practices?
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Bridge to Mastery offers periodic live retreats in the USA. Would you be interested in attending a retreat?
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Please Select One
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Please Select
Married
Single
Divorced
Separated
Widowed
Darren likes to do the consultations using Zoom online conference, which is similar to Skype. Please indicate your preference, which will be honored:
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I can do the Zoom conference by computer
I prefer to do the consultation by telephone
I prefer to do the session in person in Fairfax California at Darren’s office
Is there anything else you’d like to share or ask?
Verify that you are a human
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