Personal Enrichment Program Application

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Perfect for individuals and couples who want to enhance intimacy, increase sexual comfort, and expand pleasure.

Date:

Your Name:

Email Address:

Postal Address:



City:

State:

Zip:

Day Phone:                         Evening Phone:

Birth date:                           Sexual Orientation:

Current Occupation:


Any special needs:




Dates and time you are available to participate:




Dates unavailable:

Using additional pages, please write a several page letter that answers the following questions:
1) Why do you want to participate in the Personal Enrichment Program (PEP)?
2) What are your goals and concerns regarding participation in PEP?
3) Describe the circumstances of your early life and the major emotional and sexual experiences and relationships that have influenced you since birth. This essay is about your personal and sexual evolution—it is likely to be at least a couple pages long, and should include an overview of the following:

• Highlights of the relationships and experiences with important people in your life (parents, peers, lovers)
• Therapy experiences
• Your feelings about your body and your feelings about nudity
• Your enjoyment or difficulties with physical and emotional intimacy
• Your capacity for candid conversations about sex, love and intimacy
• Your current relationship status and sexual orientation

Mail your application and the enclosed informed consent form to:

IPSA Training Coordinator
3428 Motor Avenue
Los Angeles, CA 90034