Circle of InnerVisions inc.

On-line Application

Please fill out the necessary information - Thank you

First Name

Last Name

Middle Initial

Date of Birth

Sex Male Female

Please provide the following contact information:

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Home Phone

FAX

E-mail

Please supply us with two names and email addresses to be used for reference purposes. (The application will not be processed without this information.)

How do you connect to the internet?

What is the name you would like to use as your working InnerVisions name?

What position(s) are you applying to the Circle of InnerVisions Forum for?

Reader
Healer
Host
Instructor
Message Board Host
Dream Interpreter
Other

If answered Yes to "Healer", please describe your healing gifts.

If you answered Yes to "Other", please describe what is meant by other.

When would you be available to volunteer for the Circle of InnerVisions Forum?

8am thru 4pm
4pm thru 8pm
8pm thru Midnight
Weekdays
Weekends

Have you ever worked for another on-line Forum before?

Yes No

If "yes" what Forum?

If "Yes" to working previously for another Forum, please give date started.

-- mm/dd/yy

Date left other on-line Forum

-- mm/dd/yy

What do you feel you can contribute to the Circle of InnerVisions Forum?

I authorize that to be my (electronic) "signature", I attest that all of the information I have supplied is true and accurate. If it is discovered that I have submitted false information on this application, I realize that my application may be rejected and/or that I may be dismissed from my position with the Circle of InnerVisions inc. Forum with cause.
Please copy entire application and send to: INVSMgr@aol.com

*First Name*
*Last Name*
*Middle Initial*
*Date of Birth*
*Sex*	Male Female

*Street Address*
*Address (cont.)*
*City*
*State/Province*
*Zip/Postal Code*
*Country*
*Home Phone*
*FAX*
*E-mail*