Connecting People On Their Spiritual Path

Date*
Date Format: DD slash MM slash YYYY
Name*
First Last
Address*
Address line 1 Address line 2 Town/suburb State Postcode
Email*
Phone*
Membership Level Options*
Select a 1 year membership to IPMI-Australia.
Have you experienced the 1001 Profile?*
- Yes
- No
Are you a Contracted Instructor with the Wayshowers College?
- Yes
- No
Date Signed as a Contracted Instructor.
Who did your 1001 Profile?
Approximate Date of your 1001 Profile
Date Format: DD dash MM dash YYYY
Let us know your first and second gift
Example - Vision Feeling
For Platinum Membership, please list date of the following profiles: 1001s, 1002a, 1003a, and 7004
Example, 1002a March 2009; 1001s April 2009, 1003a May 2010, 7004 June 2010. All profiles are a prerequisite for Platinum Membership.
Membership Total
$ 0.00
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