Physical Mediumship Coaching Program Application
Flow with Universal Wisdom
Applicant Name
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First Name
Middle Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Website
Please share link to your main professional website and/or social media
What prompted you to seek this training?
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Where did you hear about this coaching program? Please include details and referrals, as applicable.
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Briefly describe yourself (300 words or less)
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Please provide an estimate on the proficiency of each spiritual gift:
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Not Developed
Somewhat Developed
Developed
Proficient
Clairvoyance
Clairaudience
Clairsentience
Claircognizance
Clairsalience
Clairgustance
What do you know about your spiritual guides and how does each work with you.
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Do you sit regularly in a home circle?
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Yes
No
Other
If yes, how many years total have you been sitting in home circles?
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What types of phenomena has your home circles experienced?
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Atmospheric Changes (wind, temperature, fog, color)
Spirit Lights, or "orbs"
Levitation
Apportation
Direct or Indirect Voice
Materialization
Precipitation
Show of Ectoplasm
Healing
Other
Please describe any other relevant experiences or details from your home circle sittings.
Why do you wish to become familiar with the techniques of physical mediumship?
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Have you sat in circle with a professional physical medium?
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Yes
No
Do you currently able to reach states of deep trance in home circle?
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Yes
No
Unsure
Other
If developed, how would you use the gifts of physical mediumship?
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Briefly describe your training to date in the field of physical mediumship.
Do you engage in professional counseling or use drugs in any form for mental balance?
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Yes
No
Prefer not to answer
Other
What would make this coaching experience a "home run" for you?
Signature
*
"Participant"
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