Partnership Application

Successful Living Through a Discovery
of One's Own Wisdom & Wellbeing

Application for "Two Are Better Than One" - Freedom From Habits

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Name (NOTE: all info is confidential and only seen by R. Henry Harris) *

First

Last

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Email *

Date of Birth (mm/dd/year) *

What habit(s) are you looking to gain freedom from? *

Why do you want to join want to join this trial partnership? What do you hope to gain? contribute? *

Submit

Phone:
(845) 393-1529