Discovery! Program Registration

Program Registration for Spiritual

All fields must be completed even if you use N/A.

		Year you will be attending:

	First Name:	Class#:

	Last Name:	Home Phone:

	Address:	Work Phone:

	City:	Cell Phone:

	State:	Email:

	Zip:	Marital Status:

	Age:	DOB:

	Emergency Contact Name & Phone Number:

	Referred By:	Occupation:

	Month/Year Attended D1	Month/Year Attended D2

	Month/Year Attended D3-Mission	Month/Year Attended Refocus

	Month/Year Attended Relationship	Is this your first time attending Spiritual?

	What is your Spiritual Orientation?

	What do you want to get out of Spiritual?

	Roomate Preference

	Will you be staying at the hotel Friday and Saturday or Saturday only?


A successful submission will take you to the Payment page.

Discovery One

D1 identifies the obstacles and experiences in your life that have prevented you from living a life that is REAL.

Discovery Two

D2 further develops the tools you need to get the positive results that you desire.

Discovery Three Mission

D3-MISSION uncovers your greatest assets and reveals your personal mission in life.

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