Astrology Research Reading Screening Questionnaire

Dear Sir or Madam,

Thank you for your interest in participating in an astrological research project. To see if you have the particular type of chart we are looking to research, please fill out this 2-5 minute survey. If you are a match, you will be contacted to have your reading scheduled.

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1

Please select your level of familiarity with Astrology

Select one or more answers
2

Please select your sun sign.

Select one or more answers
3

What is your primary interest in astrology?

Select one or more answers
4

How strong would you rate your belief in astrology? A rating of "7" would be a definite believer, and a rating of "1" would be a definite non-believer.

Select one answer
5

Which belief systems best represent you?

Select one or more answers
6

Please enter your birthday, birth year, birth time, and birth place. (ex. March 15th 1989, 12:06pm in Yakama, Washington). If you do not know one or more pieces of your birth info (or do not wish to provide it) please write "unknown" in its place.

7

If selected for a reading, are aware that your reading have notes taken on it? Notes will not be published and data points taken from any individual's or group of individuals' chart(s) will remain anonymous.

Select one answer
8

Thank you for completing the survey! Please provide a contact email to write to if you are selected to receive a reading. This info will only be used if you are good candidate for our research project and will otherwise be deleted.

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