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The journey of a thousand miles begins with a single step.

                                                      ~ Lao Tzu

Please complete this questionnaire.

The questionnaire is designed that you MUST ANSWER every question for us to receive your form.

Please answer each question in the box and then click the blue NEXT button at the bottom right.

Please click start and follow your heart!

Start

Question 1 of 9

From where will you be traveling?

Question 2 of 9

Tell me why you want to come to this retreat. What do you hope to take away from this experience?

Question 3 of 9

What are you most excited to bring to this experience?

Question 4 of 9

Space is very limited and I want to make sure this is a good fit. Why should I choose you?

Question 5 of 9

The price for the Sedona Spiritual Healing Immersion Retreat is $3,600 per person, not including flights & hotel. There is also a $4,900 option that includes accommodations. Please check yes if you are willing to pay one of these amounts. (This is not a commitment ~ I just need to know that you are serious, so I can follow-up with you).

A

Yes

B

Probably

Question 6 of 9

In order for me to follow up with you, please enter your first and last name in the space below.

Question 7 of 9

Please enter your Street Address, City, State / Province, Zip / Postal Code, and Country.

Question 8 of 9

Please provide your phone (cell phone) number.

Question 9 of 9

Please provide your email address.

Confirm and Submit