SCHOOL OF TANTRA CLASSES & EVENTS REGISTRATION FORM You must complete a REGISTRATION FORM and one of the following to register for TANTRA SCHOOL: ADMISSIONS APPLICATION | SCHOLARSHIP APPLICATION | SPONSOR APPLICATION EVENTS REGISTRATION FORM

Person One Information: First Name _______________________________  Last Name  ______________________  I am male ____;  female _____;  couple ______;  single _____; In a relationship but coming as a single ___ *Birth date:  Month ________  Day ________  Year ______ Email  _________________________________  I wish to receive the newsletter?  Yes _____  No _____ Person Two Information: First Name _______________________________  Last Name  ______________________  I am male ____;  female _____;  couple ______;  single _____; In a relationship but coming as a single ___ *Birth date:  Month ________  Day ________  Year ______ Email  _________________________________  I wish to receive the newsletter?  Yes _____  No _____ One person only needs to complete the rest of the application even if there are two people: Telephone:    Home  (____)______________________  Work: (____)_______________________                      Cell:   (____)______________________ Address: Street _________________________________ City: _________________________________  State/Province: _________________________  Zip: ______________   Country: _______________________ ______  I verify that I am at least 18 years of age*. *(You must be 18 or older. Positive ID showing proof of age is required) What is your relationship status?  _______________________ I am (pick the one that best describes you)  ______ Monogamous _____   Polyamorous _____   Lifestyler _____   Playcouple  _____   Curious about the lifestyles What is your sexual orientation?  ________________________ Do you have any experience with tantra?  _____________________ What attracts you to our DreamMatch Clubs?  ___________________________ Do you hope to find a date at this party/event?  If so, indicate which of the below you are seeking: ____ single man;  _____  single woman;  _____ couple;  _____ triad;   _____ foursome;  ______ group Signature:  __________________________________________ ANNUAL DreamMaker MEMBERSHIP FEE: Good for DreamMaker Dating & Relationship Clubs and Introduction Service: MINGLES FOR SINGLES, TANTRA CONNECTION, POLYAMORY CONNECTION or CLUB TANTRA.. Membership fee must be renewed each year.  $150 single, $150 couple, $200 triad.  Note:  Membership Fee includes the initial orientation interview.     You must complete one of the following: Tantra Orientation Interview, Polyamory Orientation Interview or Mingles Orienation Interview ($150) before you can participate in our DreamMaker dating/relationship groups and parties. Please complete an Orientation Interview Application. Our groups are for singles, couples, triads, groups. All relationship styles and sexual orientations welcome.  DreamMatch Groups & Parties: $100 single admission - singles or couples, $200 triad.
MEMBERSHIP
ANNUAL MEMBERSHIP FEE: Good for all our DreamMaker Clubs and Introduction Groups: MINGLES FOR SINGLES, TANTRA CONNECTION, POLYAMORY CONNECTION or CLUB TANTRA and includes your Orientation Interview or Annual Review.
Single	Couple/Pair	Triad
___ $150 single	___  $150 couple/pair	___ $200 triad
___ $100 Single Admission	___ $100 Single Admission	___ $200 Single Admission
___ $1000 Annual Pass	___ $1000 Annual Pass	___ $2000 Annual Pass
Date you'd like your Orientation Interview/Tantra Basic Class: ___________  Time ________  AM ___  PM ___
MINGLES FOR SINGLES GROUP: (Meets Fridays, 7pm) For Monogamous Singles: Heterosexual, Gay and/or Lesbian
TANTRA CONNECTION:Tantra Group for singles, couples, triads, all orientations and relationship styles. (Ongoing beginning/intermediate level tantra group: Meets Thursdays, 7PM)
CLUB TANTRA PRIVATE CLASS & PARTY: (advanced level party, gender balanced: (Meets Saturdays, 7PM) For singles, couples, triads, groups, all orientations (straight, gay, lesbian, bi) and relationship styles  (monogamous, swingers, lifestylers, playcouples, polyamorous, etc.) welcome.
POLYAMORY CONNECTION: Ongoing Dating/Study Group for those interested in polyamory, swinging, pair-dating and lifestyle activites.  Polyamory Connection Meets Wednesdays, 7PM, Monthly.
DreamMaker Mixers - Mixers meet last Saturday, 7PM, Monthly Date you'd like to attend: ___________
WEEKEND PLAYSHOPS
CELEBRATE SACRED SEXUALITY: Maui, HI - 3rd weekend every month, Saturday 9AM - 5PM, Sunday 11AM - 6PM Three-Day Seminar: ___ $395 Singles ___ $495 Pairs     Two-Day Seminars: ___ $295 Singles ___ $395 Pairs     One-Day Seminars: ___ $145 Singles ___ $195 Pairs  (One Day Seminars: Adore Aphrodite, focus on the woman) Single Day of a Mutiple-Day Seminar: ___ $165 Singles ___ $225 Pairs
PASSION & POLY PLAY IN PARADISE: Maui, HI - 1st weekend every month, Saturday 9AM - 5PM, Sunday 11AM - 6PM
Three-Day Seminar: ___ $395 Singles ___ $495 Pairs     Two-Day Seminars: ___ $295 Singles ___ $395 Pairs     One-Day Seminars: ___ $145 Singles ___ $195 Pairs  (One Day Seminars: Adore Aphrodite, focus on the woman) Single Day of a Mutiple-Day Seminar: ___ $165 Singles ___ $225 Pairs

POLY TRIBE: Roleplay Polyamory Tribe for a Week December and July in Maui, Hawaii (see Calendar for Dates and Times) ___ $795 (2 or more single students) ___ $1495 one student ___ $1495 a pair (you must register at the same time to get this discount) EDUCATION & CERTIFICATION CLASSES ___ $595 single :      ___ $995 pair Repeat a level, tuition is ___ $295 single, ___ $495 pair (You must attend in person to get this discounted price) Electronic Class  - IUPS (International University for Professional Studies) $200  ____ IUPS (International University for Professional Studies) courses: $200  ___ Private Tutorials - $150 an hour ___ for ___ hours E-MAIL CORRESPONDENCE CLASSES ___ $50 ungraded ___ $100 graded and applicable towards certification. Name of Class  ___________________________________________________________________ In addition to your e-mail class, telephone tutoring is available for $75 per 30 minutes.  Appointment for phone classes must be scheduled in advance of the session. Telephone Tutoring ____ for ____ hours.  ($150 hour, 30 minute minimum sessions) Once you begin a given class, you have 90 days to complete it in order to receive credit.  Professor Lessin will respond within 30 days to your homework.  If further correction is needed, student will be given another 30 days to make the suggested corrections.

GROUPS

____ Alien Experience: Breaking the Godspell Study Group $200/10 weeks  ___ $25 per week

____ Dreamwork Workshop $125

____ Existential Life Review Group $125/3 hours

____ Gestalt Therapy Workshop $125 (includes book)

____ Holotropic Breathwork Group Class $125/day (includes book)

____ Jealousy Management Workshop: From Jealousy to Empathy - 1 day ($125)

____ Journey To Tomorrow - $12 (includes book)

____ Men's Group $200/10 weeks  ___ $25 per week

____ Vini Yoga Group $15

____ Voice Dialogue Group $125/3 hours

____ Woman's Circle $200/10 weeks  ___ $25 per week

PRIVATE CLASSES & COUNSELING

____ Alien Experience Integration $150 hour, ___ hours

____ Childhood Regression $150/hour, ___ hours

____ Counseling $150/hour, ___ hours

____ Dreamwork $150/hour, ___ hours

____ Existential Life Review  $150/hour, ___ hours

____ Gestalt Therapy $150 hour, ___ hours

____ Holotropic Breathwork/Spiritual Emergence $150/hour, ___ hours

____ Hypnotherapy, Childhood Regression/Futurelife Progression $150/hour, ___ hours

____ Past-Life Regression, Future-Life Progression $150hour, ___ hours

____ Personal Growth Coaching $150/hour, ___ hours

____ Spiritual Releasement Therapy $150 hour, ___ hours

____ Spiritual Emergence/Emergency $150 hour, ___ hours

____ Voice Dialogue $150 hour, ___ hours

Date you'd like your appointment: ___________  Time ________  AM ___  PM ___

POLYAMORY * LIFESTYLES * SWINGING

____ Alternative Lifestlyes/Polyamory Counseling $150/hour, ___ hours

Date you'd like your appointment: ___________  Time ________  AM ___  PM ___

TANTRA

____ Couples Tantra Massage $150/hour, ___ hours (instructional class.  Couples do massage with each other).

____ Tantra Coaching/Counseling $150/hour, ___ hours

____ Adore Aphrodite (Tantra: Loving A Woman) $150/hour, ___ hours

____ Delight Dionysius (Tantra: Loving A Man) $150/hour, ___ hours

____ Share Shakti & Shiva (Tantra: Loving Each Other) $150/hour, ___ hours

YOGA

____ Vini Yoga $85 hour, ___ hours

Date you'd like your appointment: ___________  Time ________  AM ___  PM ___

One person only needs to complete the rest of the application even if there are two people:

Telephone:    Home  (____)______________________  Work: (____)_______________________ 

                    Cell:   (____)______________________

Address: Street _________________________________ City: _________________________________ 

State/Province: _________________________  Zip: ______________   Country: _______________________

______  I verify that I am at least 18 years of age*.

*(You must be 18 or older. Positive ID showing proof of age is required)

What is your relationship status?  _______________________

I am (pick the one that best describes you) 
______ Monogamous
_____   Polyamorous
_____   Lifestyler
_____   Playcouple 
_____   Curious about the lifestyles

What is your sexual orientation?  ________________________

Do you have any experience with tantra?  _____________________

What attracts you to our DreamMatch Clubs?  ___________________________

Do you hope to find a date at this party/event?  If so, indicate which of the below you are seeking:

____ single man;  _____  single woman;  _____ couple;  _____ triad;   _____ foursome;  ______ group

Signature:  __________________________________________

Registration Options

___ Check  (Note: check must arrive by Wednesday before the event in order for you to be granted admittance).  

___ Money Order

___ Credit Card (CC number, name on credit card, expiration date, billing address, phone, email address (for electronic receipt). Fill out section below.

Accommodations:

____  I need accommodations for these DATES _______________    

Groups begin 7PM and officially end at 10 PM with the exception of Club Tantra which ends at midnight.   you intend to stay past midnight, you must arrange for accommodations.  Please indicate your 1st, 2nd and 3rd choice of accommodations.  You will be sent written confirmation of your reservation.  Accommodations are granted based on availability and location of the event.  Prices listed are approximations and availability may vary based on party location.  Please register in advance to secure your preference.

____ Dorm Space ($35/night single, $40 couple) Futons are available on a limited basis. Register early to guarantee a futon.  

____ Private Room/Shared Bath ($65 night)

 ___ Private Room/Private Bath ($75 night)    

I plan to arrive on DATE __________   TIME _____

PAYMENT BY: _____ CHECK / _____ VISA* / ____MC* / ____ MONEY ORDER _____ 

If your check, credit card, or money order is covering anyone other than yourself, please say who you are paying for and give their e-mail address and phone number.

 _________________________________________________________________________________________

CREDIT CARD INFORMATION
Credit Card payments will appear on your statements as paid to “World Tantra Association”

Name on Credit Card (including any middle initial): 

First  __________________________     Middle Initial _____  

Last ____________________________________
                                            

Complete Billing address on Credit Card: 

Street  ________________________________________________  City ______________________________

State/Providence _________________________________  Zip _______________________    

Country _________________                                                                                                                                                    

Credit Card Number: ___________________________________ Expiration date :_____/______/

Signature:  _________________________________________

(I hereby authorize this transaction and agree to the terms on this form).

 

Application Processing Fee and Orientation Interview Cost: $150 *

* All students must complete an Application plus Orientation Interview before admission to our programs and events.  Interview can be in person or via phone. If your total for groups and classes is more than $500, Orientation Interview is Free.  Orientation Interview Cost: $150. (Single women are Free until September 30, 2005)

Please complete a REGISTRATION FORM to register for events or classes.  Send completed forms to the address at the end of this form.   call and schedule your private orientation interview or let us know which Friday you'll be attending the group orientation interview. 

Date/Time I want my appointment _________________ AM/PM     ____ Phone,    ___ In Person 
___ Group Orientation: Friday, 5PM. 

I want to attend my interview: 
___ by myself
___ with ________________________ (name of person)
 

TOTAL AMOUNT PAID: $ ________  DreamMaker membership fees and party admission must be paid in full when making reservations.  All other events, groups, private instructions and accommodations require a 50% deposit to hold your time and space and the balance is due one week before the event or appointment.  This document must be signed and delivered to us in order to process credit card transactions and secure your time and space at our events.  

* NOTE: These groups are for Member's only.  Location of the events may vary.  Members agree to keep the location of the events private.  You must provide an accurate email or phone number in order to get directions.  If you've not received directions by the day of the party, call 808-244-4103 by 4pm the day of the event to get directions.  

Please be on time.  Give yourself plenty of time to find the place.  Refund policy is strictly adhered to, so be sure you want to attend before registering.  These events are structured and begin on time.  No late admittance..   

No refunds on the day of the event or 5 days prior to the event.  

CANCELLATION FEES
If you cancel 90 days or more - your penalty is 25% of price 
if you cancel 60 days or more - your penalty is 40% of price 
if you cancel 31-59 days - your penalty is 50% of price 
if you cancel 6-30 days - your penality is 75% of price