Name
              
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                    First Name 
                   
                
                
                  
                    Last Name 
                   
                
               
            
            
            
            
            
            
        
          
          
            
            
            
            
            
              
                
            
              Email
              
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              Phone Number
              
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              Which DREAM School course(s) or programming are you interested in?
              
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                DREAM School's Elder Council will take your interest into consideration when determining if your are ready to join DREAM School
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
              
                
            
              Why are you interested in learning about ancestral dream practices?
              
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               What is your relationship to Africa, South America, or people Indigenous to North America? Where are your people from? 
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Are your current needs for access to housing and food being met?
              
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                    Yes 
                  
                    No 
                  
                   
              
            
            
            
            
            
            
            
        
          
          
            
            
            
              
                
            
              What is yearly combined household income?
              
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              What is your current budget for services?
              
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                Check all that apply. 
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Do you have a Health Savings Plan / Flex Pay account?
              
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                    Yes 
                  
                    No 
                  
                    Maybe 
                  
                   
              
            
            
            
            
            
            
            
        
          
          
            
            
            
              
                
            
              What is your current spiritual practice?
              
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              How do you learn best? What is your experience with online learning?
              
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              Do you have time and emotional-mental space for deep introspection?
              
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              How did you find out about DREAM School?
              
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              Anything else you'd like to share or ask?