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First Name *
Last Name *
Email *
Phone Number *
Skype ID
Location *
Website (if you have one)
In a few sentences, briefly describe why you are interested in taking this training. *
Are you a (check all that apply) *

Have you worked with Meryl or purchased any of her programs? If so, which ones? *
If you are working with clients, briefly describe your business as it is right now (length of time, number of clients) *
What is the single biggest challenge you’d like support with? *
Have you been trained in energy psychology and/or energy medicine? If so, please list the modalities and the levels of training. *
Do you currently incorporate energy psychology techniques in your work? If so, how? *
Why are you interested in becoming a SourceTapping® practitioner? *
What do you hope the SourceTapping® training can do for you? (check all that apply) *

On a scale of 1-10 (10 is high), how prepared are you to invest your energy, time, and money into acquiring the training that will give you compentency and confidence in being a SourceTapping® Practitioner? Please explain. *
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