Love Questionnaire

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Love Questionnaire

Please fill out this application to the best of your ability. It will be reviewed and you'll be responded to via email. Please know that all of your personal information is strictly held privately, and read only by Suzanne Goulet.

* Indicates required field

Name *

First

Last

Email *

City, State, Country *

Time Zone *

If you are in a country other than the US, do you have access to Skype? *

Yes No I prefer to use my phone

What is your age, gender and sexual orientation? *

Are you currently single? *

Yes No

If yes, how long have you been single? *

1 - 3 months 6 - 12 months 1 - 3 years 3 years or more

If no, please describe your current situation and why you feel ready to bring a new Love into your life now? *

What books have you read or teachers have you tried in the past? What didn't work for you? *

Do you have any type of spiritual or religious practice that you participate in? If so, for how long have you been on this path? *

Please describe how you feel your life will be different once you have a divinely inspired Love in your life? *

Please describe your current workload and availability to participate in homework or integration periods on your own: *

Although my schedule is quite full, I am willing to carve out an hour a day to keep up with the course. My schedule is so full, I don't think I can take anything else on. I have lots of free time, love learning, and look forward to devoting myself to magnetizing my beloved

Submit

Thank you and we'll be in touch with you soon!

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