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* 1. Contact Information

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* 2. Affiliation (check one)

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* 3. Ministry Information

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* 4. When did you complete or when will you complete the 21 Day Quantum Living Process (formerly the Q Process)? Note: The Quantum Living Course must be scheduled and completed prior to the end of the first quarter, and can be taken by any certified trainer.

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* 5. Who was the Quantum Living Coach that taught, or will teach the course? And who led or will lead the debriefing process?

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* 6. Are you a Certified Quantum Living Process Facilitator (Q Coach)?

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* 7. If NO, are you interested in becoming a Certified Quantum Living Process Facilitator (Q Coach) in the future?

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* 8. What is your current ROLE (minister, board/council member, lay leader, volunteer, etc.)?

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* 9. Tuition Payment Schedule
Tuition Cost is $7,000 for the entirety of the program. Payments can be made per quarter. Please see the attached tuition payment schedule.

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* 10. When do you plan to start?

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* 11. Please note: Anyone taking courses must be enrolled with UWSI. Upon receipt of this application, we will check our records. If you are not enrolled, we will reach out and request that you complete an enrollment application and pay a one-time, non-refundable $35.00 fee.

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