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Application & Registration Form--the Dream House 2000-2001 General instructions: Please either print this form out and fill it in on regular paper and ink, or copy it into your word processing program and fill it out there. Sorry, we haven't figured out how to make a totally online application form, and for legal purposes we need your non-virtual signatures anyhow. When you're finished, mail it with your deposit to The Dream House, c/o Genius Tribe, P.O. Box 1014, Eugene, OR 97440. [Note: As of May 5, we're having a hard time getting this all to print out correctly. You may need to copy it to your word processor rather than print it directly from the internet. If you'd rather have a paper copy, call our office and we'll send you one.] We suggest you keep a copy of your application for your records. For additional pertinent information about signing up, click here. the basics Which session(s) are you registering for?________________ Session 1 (October 9-December 18, 2000) *** Session 2 (January 3-March 14, 2001) Session 3 (March 26-June 4, 2001) *** Session 4 (June 8-August 17, 2001--these dates might change slightly depending on our 2001 Not Back to School Camp schedule) Please note that we will not cash deposit checks for sessions 3 and 4 until 3 months prior to the start of the session. Nonetheless, your deposit check is required to reserve your spot. Also, we are not currently taking reservations for sessions after summer 2001. Your legal name (first, last, middle name or initial): __________________________________ preferred nickname if different: _________________ Your birthdate (month, day, year):______________ How old will you be on the first day of the session you are registering for?__________ Your email address (please provide an address that you expect to keep until at least the first day of the session you are registering for): __________________________ Your street address:______________________________ City:__________________________ State or province:_____________ zip or postal code:_______________ Country if not U.S.:______________ Daytime phone number:_________________ Evening phone number:_________________ mother's (or guardian's) name (first and last):__________________________________ her contact info if different from yours (street address, city, state, zip, phone numbers): ___________________________________________________ ___________________________________________________ father's (or guardian's) name (first and last):__________________________________ his contact info if different from yours or your mother's (street address, city, state, zip, phone numbers): ___________________________________________________ ___________________________________________________ May we give your name, email address, mailing address, and phone number to other people who register for your session? _____________ are you a dreamer? Don't let this section scare you off! Registration is first come first served--we will not be picking the "best" applications. And we don't expect to necessarily turn anyone away based on their answers to these questions. But in order to ensure a compatible group of people and a great experience for everyone, including you, we do want you to honestly address the issues below. If we have concerns after reading your responses, we will contact you and see what we might do together to help the dream house work for you and vice versa. It's possible that together we will decide that we're not compatible, but only after brainstorming and creatively exploring our options. We also hope that by answering these questions, you yourself will get a clearer picture as to whether living at the dream house is right for you.
Please read the following paragraph (from our page, Are You a Dreamer?)..... People who get the most out of
the Dream House will be flexible, not dogmatic or preachy about their
beliefs (including politics and food choices), curious, open-minded,
friendly, cooperative, open and direct rather than gossipy. They'll be
willing to be tidy, but not too easily annoyed by a little messiness
caused by other people; they'll be willing to be quiet, but not too easily
disturbed by other people's noises. ....and please write a few sentences (more if you wish) about how you see yourself in relation to our comments. Don't try to convince us you're perfect; just try to give us a realistic idea of your strengths and weaknesses.
do you snore?_______________ are you a light sleeper easily disturbed by noise? if so, are you willing to use earplugs and do earplugs enable you to get enough sleep?____________________________________________________________ ____________________________________________________________ are you a night person or a day person? what time do you prefer to go to bed and get up? how flexible are you about this? ____________________________________________________________ ___________________________________________________________________________ are you willing to take short showers most of the time? how short? _______________ how do you feel about eating mainly vegetarian food during your dream house session(s)? _____________________________________________ Do you agree to do all of the following?
Do you have any physical challenges which might make it difficult for you to live at the Dream House? If so, please describe them and also describe what kind of help or accommodation might make it easier for you to join us. ________________________________________________________ ____________________________________________________________________________________ Do you have any concerns about living at the Dream House? ____________________________________________________________________________________ Why do you want to come to the Dream House?____________________________ ____________________________________________________________________________________
money The standard fee for a 10-week session at the Dream House is $3105 (click here for an explanation of why we say $3105 instead of the $3000 we listed earlier). We require a $1,035 deposit to hold your place. People who apply for $500 work trade scholarships must also send in a $1035 deposit. If you are applying for one of our larger ($1750) scholarships, and can only attend the dream house if you receive one, you may pay a $517.50 deposit. If you are applying for one of these $1750 scholarships BUT will attend the Dream House whether or not you receive one, THEN you must still send in a $1035 deposit. (For essential information about money, scholarships, paying by credit card, deposits, and our refund policies and payment schedule, click here.) Please carefully read through ALL of the following options, and then check the one that applies to you. _________(1) I am not applying for a scholarship and will pay a total of $3105. I prefer to pay by credit card. Please charge the following Visa or MasterCard for $1035. (Note: your credit card will NOT be automatically charged for any further payments.) credit card number:_______________________________________ expiration date: _____________________ _________#1 above applies to me, except that I agree to pay with a check or money order for a 3.5% discount. I am enclosing $1000 and will pay a total of $3000. _________#2 above applies to me, except that I agree to pay with a check or money order for a 3.5% discount. I am enclosing $1000. _________#3 above applies to me, except that I agree to pay with a check or money order for a 3.5% discount. I am enclosing $1000. _________#4 above applies to me, except that I agree to pay with a check or money order for a 3.5% discount. I am enclosing $517.50 which is NOT refundable even if I do not receive a scholarship.
now sign it Dreamers sign this statement: I have familiarized myself with the Dream House program through reading the web site and/or brochure. I certify that my statements on this application are true and factual to the best of my knowledge. I am choosing to come to the Dream House of my own free will and am not being coerced into doing so by a parent/guardian or other person. I understand that if I violate significant house rules repeatedly or in a way that the staff considers seriously threatening to others' Dream House experiences, I will be sent home immediately at my own expense, without any refund of my fees. I understand that my deposit is non-refundable unless the Dream House session I have registered for is canceled, or my application is not accepted, or all but $100 will be returned if the house fills up completely with 16 residents for that session. signature___________________________________ date____________ And parents (of minors) sign this statement. Dreamers age 18+ sign it yourself: I have familiarized myself with the Dream House program through reading the web site and/or brochure. I certify that the statements on this application are true and factual to the best of my knowledge. My child is choosing to come to the Dream House of her/his own free will and is not being coerced into doing so me or, as far as I know, any other person. I understand that if my son/daughter violates significant house rules repeatedly or in a way that the staff considers seriously threatening to others' Dream House experiences, he/she will be sent home immediately at his/her own expense, without any refund of fees. (I also agree to immediately reimburse the Dream House for travel expenses, if necessary.) I have read your information on money carefully, and I understand that our deposit is non-refundable unless the Dream House session we have registered for is canceled, or this application is not accepted, or all but $100 will be returned if the house fills up completely with 16 residents for that session. signature___________________________________ date____________ signature___________________________________ date____________
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