Confirmation

Confirmation

CONFIRMATION

www.FengShuiAlaska.com
FengShuiAlaska@gmail.com
(907) 830-9899

Thank you for choosing Feng Shui Alaska to conduct your Professional Feng Shui Consultation(s). Please fill in the following to ensure that we have correct information for your consultation.

To book a consultation, we request a 50% consultation payment as a final confirmation. We have a 24 hour cancellation policy. If you need to reschedule or cancel the consultation, please give us a notice in advance. If you reschedule with less than a 24 hour notice, the fee for late rescheduling is $88. If you cancel with less than a 24 hour notice, your confirmation payment is non-refundable.

First Name*
First Name*

Last Name*
Last Name*

E-mail Address*
E-mail Address*

Web Site URL*
Web Site URL*

Street Address*
Street Address*

City*
City*

State/Prov*
State/Prov*

Zip/Postal Code*
Zip/Postal Code*

Country*
Country*

Home Phone*
Home Phone*

Business Phone*
Business Phone*

Fax*
Fax*

Cell Phone

Date of Birth & Time

Birthplace

Gender

	Female
	Male

Professional Consulting Services

	Residential Consultation
	Business Consultation
	Residential/Business Consultation
	Office Consultation
	Personal Consultations
	Date Selection
	Feng Shui Events

Professional Certification Training Program

	Basic Master Practitioner Course
	Advanced Master Practitioner Course
	Master Consultant Course
	Master Consultant Internship Program
	Basic Bazi Practitioner Course
	Advanced Bazi Practitioner Course
	Bazi Consultant Course

Names of all Occupants and Gender

Date and Time of Birth for all Occupants

Building Construction Date

Moved-In Date

Renovation Date (If any)

PAYMENT:

	Cash
	Check
	Visa
	Mastercard

Credit Card No.

Exp. Date

CV2

Name of the Card

Credit Card Billing Address