Homestudy Course Application
(This information is kept completely confidential.)

Personal Info: Name: 
Address: 
City: 

State: 
Zip: 

Country: 
Phone: 

(we will NOT call you unless it’s dire…)


E-mail Address (Please type carefully): 

Date of Birth:  MM/DD/YY

Surface gender:
 

Male 

Female     {not to be confused with inner
or spiritual gender! }

Marital Status:
 

Single 

Married 

Divorced 

Too long a story for this space
Number of Children:  Boy(s) 

  Girl(s) 

Partner’s Name: 

Please check the course you would like to receive:

Psychic Counselors Course  
(Courses coming soon:  Dream Interpretation Homestudy
Course, and How To Become A Professional Tarot Reader)

Half price discount is also granted for members of the same
household.  The first person pays full tuition and the
second person pays half price if both apply at the same time.

Please enter your name exactly as you want it to appear on your
Training Certificate. 

Do you pledge to use your Counselor/Reader Status for the Service
of Humanity? 

 
Member Profile


The following questions are somewhat optional,
but we encourage you to answer them because they help us build
a picture of you and what has made you the person you are. Souls
appear and re-appear in “families” or “soul groups”. They often
follow family bloodlines, you ARE your ancestors. Past lives
are sometimes hard to believe in, but genetic memory is very
real. The things you are drawn to in life, flashbacks, and deja
vu are your genetic memory nagging you. We can better help you
get where you’re going if we have a complete profile of you
and your ancestral background.

What religion 
were you raised on?
Do you still practice its ways?
Fully 

Somewhat
Seldom 

Never
How does your immediate family feel about
your chosen spiritual path? Opposition? Approval?

Please check any of the following areas you have studied or
“dabbled” in:  {You can skip this section
if you have already filled in these questions on the Ordained
Minister’s Application.}


Kabbalah 
Esoteric Christianity
Runes
Rosicrucians

Gnosticism
Wicca or Earthbased Trads
Angels
Asatru/Heathenism

Buddhism
Ceremonial Magick
Tarot
Enochian

Goddess
Apocalyptic/ Prophecy studies
Druidry
Vedanta

Other areas of study not listed above: 

Please indicate those that you are most
interested in learning more about: 



More about you

Your occupation, 

Special Skills,
Hobbies, etc.? 

How did you hear about us?
New Age Journal
Link from TheDreamZone.com

A friend told/emailed me
Discussion List
Link from any other website

Search Engine Query
Heard Dr. Katia on a Radio Show		 Any other source: (please explain)

Payment information:

If you are petitioning for an Ordination at this time, the Ordination
fee is reduced to $75.

Please check the box next to the
items you are ordering.


    Psychic Counselors Course


    Check this box only if you want Rush shipping.  Cost varies,
    depending on where you are.

Payment Methods


    Visa 

    MasterCard 

    Discover (you will be contacted by email for your card number)


    Paypal

     

Please review your application above and if
you are happy with it, click on the button below. (Print
this now before you click “Send”  if you want to keep a
copy of this application for your records)


Home
| Site Map
| Religious Doctorate
Degrees | Become
An Ordained Minister | Practitioners
Directory |
Products & Services | Bookshop
| Esoteric Mystery
School | Homestudy
Courses |
Esoteric Marketplace
Mary Magdalene
| Knights
Templar | Divine
Feminine | Contact
Us | Esoteric
Christianity Blog

All material on
this Website is Copyrighted © 1999 – PRESENT by the Esoteric
Interfaith Church, Inc..
All rights reserved. Reproduction without written permission is prohibited.