Past Life

INTUITIVE RESEARCH

Individual Past Life Profile Request for you to print, fill out, and return to us

Name _____________________________________________________________ Date of birth _____________________
Please type/print as on birth certificate. Females who have married use most recent husband's last name.
Address __________________________________________________________________
Street number and name or Route/Box number

_________________________________________________________________________
City / State / Postal Code / Country
Phone Number ________________________________________________ email ______________________________
Occupation ____________________________________ Have you studied at the School of Metaphysics?__________
Signature (of person requesting reading) _________________________________________________
If you have questions or specific concerns please write these on the back of this sheet.
List in order of importance. If your questions exceed five please call us.

Requested minimum donation for this type of Intuitive Report is $80. Your generosity is greatly appreciated for it enables us to further our work. One hundred percent of monies received are used for expansion of SOM teachings and research.

Form of Payment (circle one): Check/Money Order (payable to School of Metaphysics) Visa Mastercard Discover

Amount enclosed $____________________________

Visa/MC Number: ______________________________________________ Expiration Date: ______________________

Signature of Cardholder: ____________________________________________________

Please send completed form with indicated form of payment to:

School of Metaphysics
World Headquarters
163 Moon Valley Road
Windyville, Missouri 65783
USA

*International orders please add $15.00 for return priority mail.
(please do not write in this box)

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