DATE:____________

LEGAL NAME:________________________________________

DATE OF BIRTH:_______________

PROFESSIONAL NAME
(name you will use online)_________________________________________

ADDRESS____________________________________________________________________________

E-MAIL ADDRESS__________________________________________

CITY_______________________________________________STATE___________________________

HOME PHONE#______________________________

PSYCHIC LINE#______________________________ SOC.SECURITY#_______________________________

ARE YOU A U.S. CITIZEN?_______________

IF "NO", ARE YOU ELIGIBLE TO WORK IN THE U.S.? _________YES ___________NO

WHO DID YOU SPEAK TO FROM OUR COMPANY?  Debbie Holder

The status for which you are applying is a contract labor position providing professional psychic, astrology or tarot card readings.  The contractor having experience in this area will set her/his own hours, work as much as she/he sees as appropriate.  Continuing status as an "Independent Contract Reader" for Visions Of Light requires the contractor to honor all individual agreements regarding each particular line you answer for.

EXPERIENCE:
List below the formal and informal training you received in the intuitive arts.
(use separate sheet if necessary)
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  List the experiences you have had as a reader and consultant:

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