T3 Registration

TRACEY L. ROGERS
ASTROLOGER + LIFE COACH

t.3 REGISTRATION FORM

Please complete the registration form below. A full date, place, and an exact time of birth (or 2-hr estimate) must be provided for an accurate astrology reading. Be sure to include your physical address to receive course materials. Your information is secure and will not be shared with others.

Once completed, click the "SUBMIT REGISTRATION" button below to proceed with payment. A confirmation message will be sent once payment is received within two business days. Email info@traceylrogers.com for any questions.

PARTICIPANT DETAILS

* Indicates required field

Name *

First

Last

Gender or Preferred Pronouns *

Best Email *

Best Contact Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

BIRTH INFORMATION

Date of Birth (MM/DD/YYYY) *

Country of Birth *

City of Birth, State of Birth (if applicable) *

Time of Birth or 2-hr estimate (12:00AM/PM) *

PROGRAM INTAKE

Where in your life do you know it's time for a big change? *

What are your strengths? Where do you feel most confident in life? *

When it comes to change, what are you most afraid of? *

What do you hope to gain from the Thriving Through Transformation program? *

By checking the boxes below, I understand and agree to the program refund policy and participation guidelines as outlined in the program FAQs. I also understand and agree that all course materials (including video recordings, program documents/resources, and program participant details) will not be shared and kept confidential.

Terms/Conditions *

Payment/Refund Policy Participation Guidelines Confidentiality Statement

Please verify that your information is correct. Click the button below to submit your form and proceed with payment.

SUBMIT REGISTRATION

t.3 REGISTRATION FORM

PARTICIPANT DETAILS

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