Name

Email Address

Gender Gender Male Female

Day of Dream Day of Dream12345678910111213141516171819202122232425262728293031

Month of Dream Month of DreamJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

Dream Year

Title of Dream (if you have one)

Check box if you were part of what was going on but not the center of attention Check box if you were part of what was going on but not the center of attention Participating in the dream

What colour was the dream in? What colour was the dream in? Colour Black and White Mixture Don't remember

What was the atmosphere of the dream? What was the atmosphere of the dream? Calm and peaceful Dark and scary Exciting Don't remember Other (specify below)

Other atmosphere

Additional Comments - include relationships to any people in the dream - e.g. Paul is my brother/boss/boyfriend etc.

The dream - tell us as much as you can about the dream