Application Form

Please fill out the application in full and mail a hard copy, together with your non-refundable application fee of $50.00 - make checks payable to JEREMY TAYLOR. Address: 736 San Pedro St, Fairfield, CA 94533.

It would also be helpful if you include a small picture (snapshots are OK) since I have trouble remembering names but will remember your face! Thanks.

Rev. Dr. Jeremy Taylor, Director

Marin Institute for Projective Dream Work

Please email for address (or call 707/422.9308)

Name:

Phone:

E-mail address:

Mail Address:

Age:

Gender Identity:

Ethnicity:

1) Do you have any ailments, impairments, injuries, Illnesses, or disabilities, physical or mental, that we should be aware of?

2) How did you hear about/become interested in the MIPD Professional Projective Dream Work Training Program?

3) What books, workshops, classes, etc., have influenced you and your interest in dreams and exploring their deeper layers of meaning?

4) What sort of religious/spiritual training/education did you get as child?

5) What other professional credentials do you already possess, or are in the process of acquiring?

6) Have you ever been convicted of any crime, (other than minor traffic violations where no physical injury was involved)? If so, please give general details.

7) What experience have you already had, working with and exploring your own and other's dreams?

8) What do you hope to gain from participating in the MIPD training program?

9) What ideas, if any, do you already have about giving your unique gifts as a dreamer and professional dream worker to the world?