Class Registration

Name*

First Last

City/State/Country*

City/Town you reside in State / Province / Region Country

Phone*

Email*

Email - Please type your email address again (you have no idea how many people get it wrong the first time!)*

Time zone you are in:*

Birth Information*

Month of birth	Day of birth	Year of birth (ex. 2015)	Time of birth - needs to be actual hour and minute(s)	City & State/Country of birth

What is the source of your birth time?*

For this class you'll need a COMPUTER and INTERNET system that's fast enough to stream youtube or netflix and a VIDEO CAMERA in your computer, allowing you to show up on video for class meetings. Do you have all that? (please say yes, or let me know what you do have)

Which class would you like to register for?*

I would like to attend..*

"I am interested in studying with Jamie because. . ." (write at least 1 paragraph)*

My previous experience with astrology is…*

Because the study of astrology is not very standardized, we all have “blank spots” in our learning. Mine are. . .*

The next step for me in filling in my knowledge is. . .*

My goals for this class are…*

I will know my goal is met when. . . (please write something specific or measurable, i.e. “I’ll be able to _____ easily, etc.)*

"Here's how I think Jamie and my classmates would benefit from (or enjoy) me being in this class. . ." (write at least 1 paragraph)*

How did you find out about this class?*

Pandora Astrology Class Registration and Goals Form

Meet Jamie

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