Please fill out the application thoroughly and honestly so that I can help to the best of my abilities.

 

First Name*

Last Name*

Email Address*

Street Address*

City*

State*

Country*

Telephone*

Skype User Name*

How did you hear about Nicole Justine?*

Why are you interested in working with Nicole Justine Reid?*

In what ways do you feel you are not fully living up to your potential?*

What do you imagine unleashing your potential would be like for you? What do you see, hear, or feel?*

What about the Ultimate Transformational VIP Day Experience are you drawn to?*

Why now?*

If you sense you have a mission or a purpose here on earth, what might it be?*

What else have you been doing to support yourself on your spiritual path?*

Describe your current relationship with God/Source/Universal Energy/your name for this higher power is.*

What are your biggest challenges to fulfilling your potential right now?*

On a scale from 1 to 10 (10 being highest), how important is it for you to fulfill your potential and expand into all of who you are as a spiritual being and earthly being?*

On a scale from 1 to 10 (10 being highest), how ready are you to invest time, energy, and money into your finding that sense of fulfillment?*

On a scale from 1 to 10 (10 being highest), how ready and committed are you for transformation now?*





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