JWApplication

Bliss & Balance Sistar!

"Every daughter of the Creator is a spark of light, and when we gather together at the end of time,
all of our sparks will illuminate the World to Come." Nomi Eve

Respectfully, the information you provide is confidential. It only goes to my, Shemora Sheikh's, email.
It is between teacher & student. If you make it into this Cycle, at some point the birth charts which are generated from this information will be shared in class with your comfort taken into consideration.
This information is not shared with any other businesses etc.

* Indicates required field

Name *

First

Last

Birthdate *

Name you prefer to be called. *

Time of Birth *

Email *

City, State you were born. *

Phone Number *

Concerns, Comments, Questions, Suggestions *

What are you looking to gain from the Journey Within? *

Why do you want to do the Journey Within? *

Why do you think you are ready for The Journey Within? *

What is your Spiritual Philosophy? *

What is your spiritual background (what belief system were you raised with)? *

Have you had your birth chart done before? *

Once group classes start, I'm aware that I may be exposed to information concerning individuals that is of a personal and confidential nature. I agree that this information will not be disclosed to any third party.Choose Any *

I agree I do not agree

Are you interested in Barter? (an energy exchange other than money)i.e. tutoring, childcare, meal prep, body care products, social media management, graphic design, cleaning, organizing, etc) *

Your Talents, Interests, Hobbies? *

Do you need help with child care? (I can recommend people close by or see if inhouse child care is an option). Starting in August we will meet weekly. *

Do You Want to Recommend someone for The Journey Within? *

Yes No Maybe

If you want to recommend someone, please provide her name, number, and email. If you do not provide the information for me to contact the person, then I will call you for the information. *

Why do you recommend this sister? *

*People who do not get into the 2022 Cycle will be a priority for the 2023 Cycle.
You can email me at shemora@passageinstitute.com
You can call me at 1-877-570-3108

Asante Sana. Dua. Shukran. Gracias. Thank You.

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