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Application for IDS Dream Certification Program

First Name *
Last Name *

Street Address 1 *
City *
State *
Postal Code *

Email *

Home Phone

Business Phone

Cell Phone

Best time to call

Current Occupation

Country of Citizenship

Birthdate

Emergency Contact

Relationship

Emergency Contact Phone

Method of Payment *

Paypal - $45 USD - (Includes processing fee)Check / Money order - $45 USD

What is your involvement in the world of dreams? (Please respond in 200 words or fewer.)

Are you currently or have you previously been involved in the field of psychology, counseling, health care, ministry, coaching, or other helping professions? If so, what field, when, and how are (were) you involved? (Please respond in 200 words or fewer.)

If you have any work and/or volunteer experience relevant to dream work, please list them.

If you have any licenses, or certifications, relevant to dreamwork and/or psychology, please list them.

Have you studied dreams through workshops, courses, conferences, and/or independent study? If so, what, when, and where?

What are your overall goals for participating in the IDS Certification Program? (Please respond in 200 words or fewer.)

This program will be conducted online via videoconferencing. Do you have (or are you willing to acquire) the technical equipment and knowledge to participate in an on-line course of this type?

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

References

Please provide the contact information for one person who can act as a reference for you, and who can speak to your dedication and commitment to dream studies, and your ability to successfully complete this course. NOTE: Your reference person can be a colleague, teacher, friend, coach, member of your faith community, or anyone else you feel knows you well enough to recommend you—but who is not a family member. Be sure to include the following information for this person:

Reference First Name

Reference Last Name

Reference Email

Reference Phone

Reference Mailing Address

A One-Sentence Reflection as to why you selected this person as your reference.

Thank you!

How did you hear about the Institute for Dream Studies?

We appreciate the time and effort you put into completing this application. We believe this process will be useful both to you, the applicant, and to us here at the Institute for Dream Studies. We applaud your initiative, your interest, and your passion for following your dreams. Upon submission, you will be taken to a Payment Page with information on how to make the Application Fee payment online or where to send via mail.

Acknowledgement (required field): *

Please check here to acknowledge that you have read and agreed to the IDS Applicant Eligibility Requirements and Informed Consent form, which can be found here: Click Here to Read,

I acknowledge I've read the IDS Applicant Eligibility Requirements *