Type in your answers and then print out your completed questionnaire, or print out the questionnaire first before filling the form.

Please answer the following questions as carefully and as accurately as you can:

1. Please tell us about yourself:

First Name
Middle Name (not initials)
Last Name

Have you ever changed or modified your names?
Yes
No

If 'Yes' please tell us your given names at birth (please ensure the spellings are correct):

Birth Name(s):

Your Gender (Sex):
Male
Female
Others (please specify)

Your sexual preference(s):
Heterosexual
Gay
Lesbian
Others (please specify)

Date of Birth:
(mm/dd/yyyy):
Time of Birth: AM PM

Place of Birth:
City/Town
State/Province Country

Marital Status:
Married
Single
Separated
Divorced
Widowed
Polygamy
Polyandry
Others (Please specify)
Have you had any changes in your marital status? (Please specify)

 

Your Employment: (i.e. what you do to earn a living and not necessarily your job titles, academic or professional qualifications):

2. List or mention three (3) important things (if any) you'd like to accomplish materially, in your life:

3.List or mention three (3) important things (if any) you'd like to accomplish spiritually, in your life:

4 Are you completely satisfied with the course and direction of your life?
Yes
No
Don't know
Can't decide

5 If not, what do you consider the major limitations (or obstacles) that prevent you from having a more fulfilling and rewarding life?
Please list them:

6. If you had the opportunity and the ability to overhaul your your life so as to derive greater happiness and satisfaction, state those changes,
qualities and attributes you'd like to see present or effected in your life:

7. If you were capable of effecting some positive changes in the world in order to make it a better place for mankind, what three (3) changes
would you like to effect?

8. Please state clearly your main reason(s) for wanting a "Life-Path Analysis" reading:

9. We now give you the opportunity to ask a maximum of three (optional) questions in any areas of your life that you may need guidance and counseling. Areas you may wish to explore might include Health and Healing, Personal Relationships (and how to improve them), Decision Making (both professionally and personally), Personal and Spiritual Growth, Etc.
In order to derive maximum benefit from this service we suggest you do not ask questions that require simple 'Yes' or 'No' answers.
Such questions do not lend themselves to the profound depth of exploration and guidance "Life-Path Analysis" is capable of giving. For example, instead of asking, "Should I marry Mary?" (a question that requires a "Yes" or "No" answer) you could ask "What would be the outcome of my marrying Mary?" This form of question allows the Operative Divine Intelligences to unravel the various layers and ramifications of the question asked and give guidance accordingly. We believe this brief explanation is of help to you. Now, you may please ask your three questions:

10. And, finally, please tell us how we can contact you:

Mailing Address:

Street Apt
City State Zip
Country

(Or you may prefer to give us your Postal Box Number if you find that more convenient).

Telephone Fax

E-mail:

11. May the Blessings and Protection of the Mighty Absolute be with you and yours always.

Please complete the questionnaire and send it with your remittance (Check or Postal Money Order) to:

StarLight Holistics
1028 N. Lake Avenue, Suite 205
Pasadena, CA 91104

Fine Prints:
"Life-Path Analysis" involves four to five hours of very intense work. Our normal fees for this service is $300.00 U.S., but for a limited time only (subject to our discretion) we're making it available to you for only $100.00 U.S. Please allow up to 10 days for delivery.
Also, please let us know your preferred method of delivery (e-mail, postal service, or fax). Our default method of dispatching results is by United States Postal Service.

(We do not yet accept credit cards)

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