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The Ascension Program
Application
(you may check more than one box in each category)
*
Indicates required field
Name
*
First
Last
Email
*
Age
*
under 20
20 - 40
over 40
My Time Zone is
*
I am interested in
*
Distance Sessions
In-Person sessions in Vancouver
In-Person sessions on Salt Spring Island
A combination of Distance and In-Person
Previous Spiritual Development practices / experience
*
None
Limited meditation
Regular and experienced meditator
Yoga / Tai Qi / Qi Gong
Plant spirit medicine
Energy healing modalities
Intuitive
Event/s (ie a NDE)
Other
If Other please specify
*
I dedicate ____ % of my time to my ascension
*
100%
75% or more
50% or more
25% or more
less than 25%
When did you start to wake up?
*
I dont understand the question
This year
2 - 3 years
Under 5 years
5 - 10 years ago
Over 10 years ago
I want to ascend because:
*
My biggest fear is:
*
What I want most in this lifetime is:
*
I am willing to
*
Change
Face my fears
Take responsibility for the outcome of my life
Create my life
Let go of my identity
None of the above
I prefer to complete this programme within:
*
3 months
6 months
12 months
I will require a payment plan:
*
No
Yes
What I want to get or expect to get out of this programme is:
*
Lets do this!
Home
About JZ
Sessions
Classes
Intuitive Acupuncture Class
ThetaHealing Classes
Testimonials
Events
Radio
Contact
✕