All questions in Red must have an answer. If answers are not supplied application will NOT be processed!

Please identify and describe yourself:

*Name:
*Date of Birth	:
Sex:	Male Female

Please provide the following contact information:

*Home Phone:
Cell Phone:
*E-mail:
Address:
City,State zip:

Please supply us with two names and email addresses to be used for reference purposes

How do you connect to the internet?

Broadband
Dial Up

What is the name you would like to use as your working INVS name (upon approval)

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

Reader
Healer
Host
Instructor
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?

Date Started:

Date Finished:

What do you feel you have to offer the circle of innervisions?