DISCOVER THE POSSIBILITY

DISCOVER THE POSSIBILITY

This is an application only and will be review by Sindy V. King.She will look at these and then if you are accepted you will get invitation phone call.Once I receive your application, I will get back to you within a few days to let you know if your application has been accepted. (I only have a limited amount of spots available.)
Name *

First Name Last Name
Email confirm appointment *
Phone number (Confirm for application approval-not share or sold to anyone else) *
Age Group

25-34 years old 35-44 years old 45-54 years old 55-64 years old 65>
MaritalStatus

Single, never married Married or domestic partnership Widowed Separated

Address

Doyou have Skype? If so, please put your Skype ID here:
What do you think has been preventing you from being in love and stay in love with “the one”? What do you find especially challenging and frustrating in terms of your past relationships or dating experiences? Please be as specific as possible and include anything else you think it’s important for me to know about yourself
Where would you like your relationship to be in 3 months? 12 months? If you were to have a discussion with Sindy in 3 months from today, and you were looking back over the past year, what would have had to happen in your life both personally and professionally, for you to feel happy with your progress? *
Where would you like your relationship to be in 3 months? 12 months? If you were to have a discussion with Sindy in 3 months from today, and you were looking back over the past year, what would have had to happen in your life both personally and professionally, for you to feel happy with your progress? *
Which personal/ spiritual products have you purchased, coaching or personal development pieces of trainingyou have attended in the past? *

On a scale of 1-10, how committed are you to changing your dating experience and approach to finding true love?

	1	2	3	4	5

1 is Worst, 5 is Best

If you had one wish you turn around your love life, what would it be and why is it important to you?
Are you willing to invest in your love life to get result in your relationship?

Yes, if it's the right fit. Yes, I'm tired of feeling this way and am ready to invest to get started. No, I'm just looking for information right now
Enter the message as it's shown *
Good Luck! There is only one way to find out for sure if you get this opportunity and that is to apply right away!
Geolocation *
Name

First Name Last Name
Should be Empty:

Now create your own JotForm - It's free! Create your own JotForm