Pre-Class Questionnaire
Please take a moment to:
- Copy this page
- Paste into a new word document
- Fill out completely (please print all areas legibly)
- Send back via email (for on-line) or return in person at the scheduled meeting (for physical)
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Name: _____________________ Date filled out: __________
Date of Birth: _______________________
Address:___________________________ Apt #: __________
PO Box: _____________
City: ________________ State: __________ Zip: _____________
Phone Number: _________________________________
Email: ________________________________________
What Class(es) / Course(s) are you interested in at this time?
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On-Line: _____ Physical: ______
What do you hope to gain / learn from these Class(es) / Course(s)?
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If you wish to study Wicca - please state what Wicca means to you personally
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What do you feel are your strengths?
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What do you feel are your weaknesses?
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Please read the Disclosures below.
*** DISCLOSURES ***
1. Persons only receive the material(s) that are paid for at any given time. 2. Any person(s) that have a failure to pay for any / all Class(es) or Course(s) in a timely manner will be immediately removed from all Class(es) / Course(s) presently and in the future.
3. Any and all money is non-refundable.
4. At any given time the Teacher(s) may ask a Student to leave the course at their own discretion(s) without prior notification(s).
5. All materials contained within all courses offered are copyrighted and may not be reproduced and / or used in any manner without prior written consent from the copyright holder.
By signing below, I fully comprehend / understand the set Disclosures and Policies of this course at this time. I agree willing to abide by set Disclosures and Policies and wholly understand that failure to do so at any given time will be considered my forfeiture of all Class(es) and Course(s).
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Printed Name Date
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Signature Date
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