Tara Dhatu Educational Program Application Profile Form

Please copy these questions with your personal answers into an email

and send it, together with a photo (JPG) to:


Legal Name: (First, Middle, Last)

Spiritual Name/s (Please explain: from what tradition; who gave you the name; what does it mean.)

What would you like us to call you?

Date of Birth

Place of Birth

Home Address





Mailing Address (if different)





Home Phone:

Cell Phone:

Work Phone: (time and days at work)

Email address:

How often do you check your email?

Your personal or Business Oriented Web Site/s:

Education (High School/College/Degrees/Technical Training)

Are you currently In school or training?­­­­­­­­­­­­­­­­­­

Current Employment:

Ethnic Background:

Are you married or in partnership?

Partner’s Name:

Do you have children? (please list the name, gender, and age of each

Spiritual Experience/background.

 What religion were you born into?

What have been the main paths that you have been involved with? (Teachers/lineage)

Do you have any background in Buddhism? (Please discuss teacher/s and lineage.)

Are you currently studying with a Lama/teacher/Guru etc?

Do you do any kind of daily spiritual practice? (for example: prayers, rituals, etc.)

Do you keep a shrine or altar?

What is your history with the Tara Dance?

How is your physical health

Mental Health?

Is there a Tara Dhatu Student Teacher you are working with currently?  Is there somebody in particular you would like to mentor you?

Are you requesting entry into the program as a Student of Tara (self exploration with no commitment to lead meetings) Level 0 or as a Student Teacher interested in Facilitating the dance as a level 1?

Is there anything else that you would like us to know about you?