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* 1. Do you experience death dreams often? (check all that apply)

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* 2. What is the current age and gender of the dreamer?

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* 3. Is this your dream you are submitting or someone else's dream?

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* 4. Please submit your death dream here in as much detail as possible.

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* 5. What questions do you have about this dream?

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* 6. What is the date that you experienced the dream you are submitting?

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* 7. How old was the dreamer when the dream was experienced?

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* 8. What do you think/feel this dream means?

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* 9. I may or may not respond to your dream submission this summer 2016. This is research for my new dream book on death dreams. By submitting your dream You grant me permission to use your dream for my research and have it published in my book on death dreams. Thank you.

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* 10. Please submit your email address.

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