2019 PDC Registration Form

2019 “Through the Seasons” Permaculture Design Course

April-November, 2019

Registration Form

Course size is limited. To reserve your space, please mail this form to Trudy Thomas, P.O. Box 15, Arcata, CA 95518. Please include a $100 deposit, payable to: The 4th Wave.

Name _____________________________________________________________

Address ___________________________________________________________

City/Zip ___________________________________________________________

Home phone _________________________________

Work phone _________________________________

Cell phone __________________________________

Email __________________________________________________

 

Amount enclosed _________________________ (Your $100 deposit is refundable should you withdraw from the course before Sept. 1, 2018.)

Diet: __ Omnivore  __ Vegetarian  __ Vegan  __ Raw

Other ___________________________

Special Diet Requirements – wheat free, dairy intolerance, nut allergies, etc.:

_______________________________________________________

What do you most want to learn from this course? _____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

 

Your skills and talents? _________________________________________________

_____________________________________________________________________

_____________________________________________________________________

 

Anything else you would like us to know about you? ____________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

 

Adventures in Permaculture, P.O. Box 15, Arcata, CA 95518