828-693-9292
Fax 828-693-1919
PO Box 1793
Flat Rock, NC 28731

Spiritual Direction &
Dream Leader Training
in the Jungian Mystical Christian Tradition

Summer Dream Conference
Application

You are beginning the application process for the Summer Dream Conference.

There is a $50 Registration Fee per person (non-refundable).

Required fields are bold.

Conference Information

Please indicate the year for which you are applying.

Year:

Personal Information

Last Name:

First Name:

Middle Name:

Preferred name/Nickname:

Title: Suffix:

Male Female

Address:

Second Address:

City: State:

Zip: Country:

Please include your area code and separate your entry with dashes (e.g. 123-456-7890)

Home Phone:

Cell Phone:

Work Phone:

Other Phone:

Fax:

Email Address:

Retype Email:

Emergency Information

Full Name:

Relationship:

Phone #1

Phone #2

Other Information

Layperson Religious Deacon Priest

Religious Affiliation:

Dream Experience:
Attended a dream group 3 or less times
Attended a dream group 4 or more times

Spouse's Name:

Room Request

Roommate Request:

Single (if available) Double

Smoker Non-smoker

Lodging Preference:
None
Cottage
Guest House
Inn

Names and ages of people coming with you (other than your spouse):

Notes

In applying, please note any medical needs such as diet or handicap accommodations. Unless otherwise informed, Kanuga will consider your application as permission to use photographs, audio/video recording of you for Kanuga promotion, its website or new media coverage. Committed to the principles of equal opportunity, The Haden Institute makes its programs available without regard to race, color, creed, religion, sex, disability, age or national origin.

Payment

Your application will be complete after your payment has been received.

Check Credit Card (VISA/MasterCard)

If you wish to pay by Credit Card, please call The Haden Institute at 828/ 693-9292.

Spiritual Direction & Dream Leader Training in the Jungian Mystical Christian Tradition

Summer Dream Conference Application

Spiritual Direction &
Dream Leader Training
in the Jungian Mystical Christian Tradition

Summer Dream Conference
Application