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TWA - Quantum Leap QES
This Form is need to get you up and running on the Quantum Enhancement System (QES) in conjunction with TWA. If you have any questions about completing this form feel fee to reach out at to - Support@thewideawakening.com. 
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Which Program Have you signed up for? *
What email do you wish us to use for this service? (This is the email you will request energy support from not for spam purposes:). *
Full Name at Birth (max 40 characters) *
Provide your first name or the name that you go by ? *
Sex at BIRTH *
Date and time of Birth *
Please guess the time if you are not sure of the exact time.
MM
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DD
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YYYY
Time
:
Street Address of Birth *
If it was in the countryside in the middle of nowhere in the back of a car we are going to need some help here. You will need to provide GPS coordinates. This is NOT your home but where you were physically born please i.e hospital etc.
City of Birth and State of Birth *
Please specify the name of the City and Province where you were born. (max 25 characters)
Country of Birth *
Please specify the name of the Country where you were born
GEO - Latitude (eg. 45.44556677)
This is really important.. Please use google maps and find the physical location of birth. Enter Latitude. If you cannot figure this out we will do our best to create this based on the information you provide. Here is a site you may find useful - Latitude and Longitude Finder: https://www.latlong.net/
GEO -Longtitude (eg. -45.44556677)
This is really important.. Please use google maps and find the physical location of birth.  Enter the LONGITUDE. If you cannot figure this out we will do our best to create this based on the information you provide.
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