|
** SOULMATE PROFILE FORM **
is FAST, Convenient, and Affordable!
Just use this SIMPLE Form to complete your Profile
so you can see how you both are effected
by PAST LIVES! Results will be
Emailed - see method of payment below.
|
For
How the Soulmate Profile
Can Help, Click Here!
For
Testimonials
About this Profile,
Click Here!
|
Survey Information
|
How did you hear about this? |
|
Why are you requesting this? |
|
What do will this do for you? |
|
Personal Information
|
[SoulMate-1]
|
Name
|
|
[SoulMate-1]
|
EMail
|
|
[SoulMate-1]
|
Month of Birth
|
Year of Birth
|
|
[SoulMate-2]
|
Name
|
|
[SoulMate-2]
|
EMail
|
|
[SoulMate-2]
|
Month of Birth
|
Year of Birth
|
COMPLETE THE LISTS to Indicate Each SoulMate's Preferences
|
[SoulMate-1]
|
Personal Beliefs?
|
|
[SoulMate-2]
|
Personal Beliefs?
|
|
|
[SoulMate-1]
|
YOUR Best
Qualities
|
|
[SoulMate-2]
|
YOUR Best
Qualities
|
|
|
[SoulMate-1]
|
Your Mate's Best
Qualities
|
|
[SoulMate-2]
|
Your Mate's Best
Qualities
|
|
|
[SoulMate-1]
|
Your
Best Skills-Talents
|
|
[SoulMate-2]
|
Your
Best Skills-Talents
|
|
|
[SoulMate-1]
|
Your Favorite Ways to Spend
Free Time
|
|
[SoulMate-2]
|
Your Favorite Ways to Spend
Free Time
|
|
|
[SoulMate-1]
|
Your
Favorite Places
in the World
|
|
[SoulMate-2]
|
Your
Favorite Places
in the World
|
|
COMPLETE THE LISTS About Your Relationship
|
[SoulMate-1]
= Your Status?
|
|
[SoulMate-2]
= Your Status?
|
|
|
[SoulMate-1]
= What Do You
ADMIRE
About Your Mate?
|
|
[SoulMate-2]
= What Do You
ADMIRE
About Your Mate?
|
|
|
[SoulMate-1]
= What Would You
CHANGE
About Your Mate?
|
|
[SoulMate-2]
= What Would You
CHANGE
About Your Mate?
|
|
|
[SoulMate-1]
= What Do You
ENJOY
About Your Mate?
|
|
[SoulMate-2]
= What Do You
ENJOY
About Your Mate?
|
|
|
[SoulMate-1]
= What Do You
FIGHT
About With Your Mate?
|
|
[SoulMate-2]
= What Do You
FIGHT
About With Your Mate?
|
|
|
[SoulMate-1]
= What Do You Want
to Know
About Your Mate?
|
ex: What karma do we have to work off?
ex: What past lives have we had as partners?
ex: What can we do to improve our relationship?
|
[SoulMate-2]
= What Do You Want
to Know
About Your Mate?
|
ex: What problems have we had in our past lives?
ex: What successes have we had in our past lives?
ex: What can we do to experience more harmony?
|
SELECT the BEST Choice about Your STYLES
(Choose Only One)
|
[SoulMate-1]
|
Energy Style
|
|
[SoulMate-2]
|
Energy Style
|
|
|
[SoulMate-1]
|
Cognitive Style
|
|
[SoulMate-2]
|
Cognitive Style
|
|
|
[SoulMate-1]
|
Sensory Style
|
|
[SoulMate-2]
|
Sensory Style
|
|
|
[SoulMate-1]
|
Organize Style
|
|
[SoulMate-2]
|
Organize Style
|
|
|
[SoulMate-1]
|
Future Style
|
|
[SoulMate-2]
|
Future Style
|
|
|
[SoulMate-1]
|
Leadership Style
|
|
[SoulMate-2]
|
Leadership Style
|
|
|
[SoulMate-1]
|
NLP Style
|
|
[SoulMate-2]
|
NLP Style
|
|
SELECT the BEST Choice about Your FILTERS
(Choose Only One)
|
[SoulMate-1]
|
Attention Filter
|
|
[SoulMate-2]
|
Attention Filter
|
|
|
[SoulMate-1]
|
Action Filter
|
|
[SoulMate-2]
|
Action Filter
|
|
|
[SoulMate-1]
|
Processing Filter
|
|
[SoulMate-2]
|
Processing Filter
|
|
|
[SoulMate-1]
|
Reference Filter
|
|
[SoulMate-2]
|
Reference Filter
|
|
|
[SoulMate-1]
|
Chunk Filter
|
|
[SoulMate-2]
|
Chunk Filter
|
|
|
[SoulMate-1]
|
Affiliation Filter
|
|
[SoulMate-2]
|
Affiliation Filter
|
|
|
[SoulMate-1]
|
Interest Filter
|
|
[SoulMate-2]
|
Interest Filter
|
|
|
[SoulMate-1]
|
Listening Filter
|
|
[SoulMate-2]
|
Listening Filter
|
|
|
[SoulMate-1]
|
Reason Filter
|
|
[SoulMate-2]
|
Reason Filter
|
|
|
[SoulMate-1]
|
Direction Filter
|
|
[SoulMate-2]
|
Direction Filter
|
|
|
[SoulMate-1]
|
Continuity Filter
|
|
[SoulMate-2]
|
Continuity Filter
|
|
|
[SoulMate-1]
|
Time Filter
|
|
[SoulMate-2]
|
Time Filter
|
|
ANSWER THE QUESTIONS with Yes -or- No
(Choose Only One)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
1.
Do you believe in the
concept of past lives?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
2.
Do you believe in the
concept of reincarnation?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
3.
Do you believe in the
concept of karma?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
4.
Do you believe that
you have lived before?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
5.
Did you believe that you
and your mate
have known one another before
in a past life?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
6.
Do you share the same beliefs with
your mate about
religion and spirituality?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
7.
Do you feel comfortable in
discussing your beliefs
about religion and spirituality?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
8.
The first time you met, did you feel
an intense spark of attraction
to your mate?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
9.
Did you and your mate feel
very comfortable with each
other, right from the beginning?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
10.
Did you and your mate feel like you
got to
know one another incredibly quickly?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
11.
Do you have thought or feelings about
your mate that do
not come from this life?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
12.
Does your mate have
good self esteem
(they feel proud of themselves
and their life)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
13.
Does your mate have
good self love
(they treat themselves with love
and kindness)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
14.
Does your mate have
self confidence
(they are sure of themselves in
public and private)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
15.
Does your mate have a
good character
(they act with honesty in public and
private)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
16.
Does your mate act like an
equal contributor
(they "do their share" and "pull
their own weight)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
17.
Is your mate
"relationship ready"
(making space for-doing work to
support the relationship)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
18.
Is your mate committed to keeping you
safe and protected
and comfortable at all times?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
19.
Is your mate committed to keeping you
connected to family, friends,
and others?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
20.
Is your mate committed to
sharing your goals and ambitions
for what you want out of life?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
21.
Does your mate put
your needs ahead of theirs
when needed (can they be altruistic)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
22.
Does your mate help you to
achieve your desires
when needed (can they be unselfish)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
23.
Does your mate make you feel like the
most important person in the world
when needed?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
24.
Does your mate
manage their anger-temper
whether it is directed at you or others?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
25.
Does your mate
manage their mood changes
whether they are with you or other
people?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
26.
Does your mate
manage their negative emotions
so that you feel comfortable?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
27.
Does your mate
use humor
or positivity to diffuse
tense situations with you or other people?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
28.
Does your mate help you to manage
your emotions by
making you feel happier or better?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
29.
Does your mate
honor and respect
your space as in your personal feelings
and your emotions?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
30.
When decisions-actions must be taken,
is your mate
willing to compromise
with you?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
31.
When decisions-actions must be taken,
is your mate
willing to cooperate
with you?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
32.
When decisions-actions must be taken,
is your mate
willing to reach a consensus
with you?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
33.
When there is a disagreement, is your
mate willing to
resolve the conflict
with you?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
34.
When there is a disagreement, is your
mate willing to
listen to your point of view?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
35.
When there is a disagreement, will your
mate
negotiate a mutually acceptable
solution?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
36.
Do you
trust your mate with
your secrets
(that they will not share them with
others)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
37.
Do you
trust your mate
with
money
(that they will handle it as you both
have agreed)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
38.
Do you
trust your mate
to be
faithful
(that they will not have sex-be
intimate with others)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
39.
Do you
trust your mate
to
take care of things
(that they will do as you
have asked)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
40.
Do you
trust your mate
to
act appropriately in public
(that they will not embarrass you)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
41.
Do you
trust your mate
to
act with your best interests at heart
(that they are on your side)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
42.
Does your mate
respect you
(always treating you like an
equal partner
in the relationship)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
43.
Does your mate really
treat your mistakes
with
compassion and understanding?
(For
What this Question Means, Click Here) |
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
44.
Does your mate treat you with
common courtesy
(showing politeness and good manners)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
45.
Does your mate
compliment you in front of others
(saying empowering and positive things)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
46.
Does your mate try to
spend more time with you
whenever they can (like coming home
early)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
47.
Does your mate
devote their full attention
to you when you are spending time
together?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
48.
Does your mate share the tasks involved
in
doing "house work"
(cleaning and other chores)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
49.
Does your mate share the tasks involved
in
doing "life tasks"
(taxes, repairs, cleaning)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
50.
Does your mate share the tasks involved
in
arranging "leisure time - entertainment"?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
51.
Does your mate support you in
your career goals
(what you want to do in professional
life)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
52.
Does your mate support you in
your educational goals
(what you want to learn)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
53.
Does your mate support you in
your financial goals
(saving-spending, business, etc)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
54.
Does your mate support your relationships
with
your family and extended family?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
55.
Does your mate support and encourage
your relationships with
your friends and coworkers?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
56.
Does your mate support you in
social activities,
especially those
not involving them?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
57.
Do you know that your mate will
"represent you" well
in public-social situations?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
58.
Do you feel comfortable with your mate
in a wide variety of
social situations and settings?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
59.
Do you feel comfortable with your mate
in the
social groups and activities
you share?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
60.
Does your mate
really listen
to you (you feel like you
were heard and understood)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
61.
Does
communication flow easily,
freely, and naturally between
you and your mate?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
62.
Do you feel comfortable telling
your mate
absolutely everything
(with nothing held back)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
63.
Does your mate
tell you first
about the most important things
going on in their life?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
64.
Does your mate confide in you as if
you were
their best friend
(are you their best friend)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
65.
Does your mate
praise you
in front of other people enough
(for what you have done well)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
66.
Does your mate treat you like
you are dating
when you are not (like trying to win
your heart)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
67.
Does your mate remember your
important anniversaries
(wedding, birthday, holiday, etc)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
68.
Does your mate
give you thoughtful gifts
(gifts that you really wanted to
receive)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
69.
Does your mate spend
enough quality time
with you (like weekends, nights,
and holidays)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
70.
Does your mate make you feel like
you are
their top priority
(before all others in their life)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
71.
Does your mate
treat you as you would wish to be
treated
(do they apply the "Golden Rule")?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
72.
Do you find your mate
physically attractive
(are their looks, build, appearance
appealing)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
73.
Do you
miss
your mate
whenever you are parted
(would you rather be together instead)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
74.
Do you get enough
physical contact
with your mate (are you together
enough physically)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
75.
Do you and your mate have the same
level of
physical energy-vitality
(waking, active hours)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
76.
Do you and your mate spend
time doing the same things together
(having shared interests)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
77.
Do you find your mate
more attractive than others
(is your mate the most attractive
person)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
78.
Does your mate
share your important values
(living according to a common set
of rules)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
79.
Does your mate
share your health values
(about eating, exercise, medications,
etc)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
80.
Does your mate
share your career values
(about choices about work versus
leisure)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
81.
Does your mate
share your money values
(about choices with spending-saving
money)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
82.
Does your mate
share your parenting values
(about children, step-children,
grandchildren)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
83.
Does your mate
share your political beliefs
and values
(about social issues/current events)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
84.
Does your mate
touch you
as often as you would like
(as in stroking, caressing, etc)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
85.
Does your mate
kiss you
as often as you would like
(and/or in the ways you like)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
86.
Does your mate
hug you
as often as you would like
(and/or in the ways you like)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
87.
Does your mate
hold hands
as often as you would like
(and/or in the ways you like)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
88.
Does your mate
say "I love you"
often enough (do they say
it in the ways you like)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
89.
Does your mate
say words of encouragement
often enough (do they say it in
the ways you like)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
90.
Are you
comfortable in communicating
to your mate what you
do and do not like sexually?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
91.
Do you
desire your mate's physical body
so that you are consistently aroused
sexually?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
92.
Does your mate
make love to you as much as you
would like
(share the same level of passion)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
93.
Does your mate
make love to you
in the ways that
you find pleasurable
(as you requested)?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
94.
Does your
mate avoid doing
those things during lovemaking
you find undesirable?
(For
What this Question Means, Click Here)
|
[SoulMate-1]
Y
N
|
[SoulMate-2]
Y
N
|
95.
Does your mate
satisfy you sexually,
meaning that do not desire
having other sexual partners?
(For
What this Question Means, Click Here)
|
Any Other Information Relevant to this
Profile
|
Other
Relevant
Information
|
|
Customer Information:
If you are paying by
credit card, you MUST complete ALL your address information.
This is REQUIRED by my bank to process your charge. This is
for YOUR safety and protects YOU against unauthorized charges.
Thank You!
|
Name
|
(required)
|
Company (if any)
|
(optional)
|
Address
|
(required)
|
City
|
(required)
|
State/Province
|
(required)
|
Country
|
(required)
|
Zip/Postal Code
|
(required)
|
Phone
|
(optional)
|
Fax
|
(optional)
|
Main EMail Address
|
(required)
|
Other EMail Address
|
(optional)
|
How do you want to
receive your Profile Results?
|
|
Payment:
For the best security with
credit cards,
print this form out and send it to:
Past Forward,
532 Old Marlton Pike, Fun Life #248, Marlton, NJ 08053
|
Payment Method
(choose only one)
|
PAY PAL -
For How to Pay by Email, Read This!
(from 3 to 7 business days to complete)
CREDIT CARD -
If Paying by Email, Read This!
(from 3 to 7 business days to complete)
MONEY ORDER -
For More, Read This!
(No Longer Accepted)
CHECK (Personal/Cashier's) -
For More, Read This!
(No Longer Accepted)
|
Cardholder's Full Name
|
|
Card Type
|
|
Card Number
(16 Digits)
|
NO SPACES OR DASHES |
Card Expiration Date
|
|
Card Security
(3 Digits)
|
EMV Mandatory:
What is this?
|
If you are NOT the Cardholder,
|
indicate your relationship to the Cardholder
|
Relationship to Cardholder
|
|
By submitting this form,
|
YOU are saying the Cardholder approves the
charge for this service
|
Fee for the Soulmate Profile is:
|
$ 35 US
|
Special Instructions
|
Questions, Comments
or Special Instructions
|
|
Request for Additional Information
|
I am interested in
getting more information about (check all you like)
|
Past Life Profile
Past Life Channeling-Healing
Past Life Karmic Threads
Higher Self Channeling-Healing
Geometric Repatterning
Remote Releasement
Your Other Healing Services
|
FOR the "Product Order Form", CLICK HERE!
FOR the "Past Life Profile Form", CLICK HERE!
FOR the "Recorded Reading Form", CLICK HERE!
FOR the "Phone Minutes Form", CLICK HERE!
FOR the "Phone Session Form", CLICK HERE!
FOR the "Remote Releasement", CLICK HERE!
FOR the "Email Reading Form", CLICK HERE!
|
Can't Read the Image? Click Here for a new one.
Our Business Address is:
PAST FORWARD
532 Old Marlton Pike,
c/o Fun Life Company LLC #248,
Marlton, NJ 08053 USA
(856) 988-9716
ellen@healpastlives.com
Thank You for Your Order!
Copyright © 2000-2023, Ellen A Mogensen,
Past & Now Forward Holistic Counseling,
Past Forward(TM) & Now Forward(TM) are trademarks of
the Fun Life Company LLC. All rights reserved.
|