Urban Permaculture Guild presents:

PERMACULTURE FIRST RESPONDER DESIGN COURSE

Download this Registration Form in Word Document

Water Management Course: December 8-10^th Schedule and Flow , Directions

Full design Course Feb 2007;  Weekends with 8 day Intensive: 
Feb 2-4, Feb 9-11 (WFA and CPR Training), & Feb 17-25.

Please complete this form and send via email to pfr@urbanpermacultureguild.org or print out and send snail mail to the following address:  



Permaculture First Responder Course 
PO Box 96, Occidental, CA 95465 
PFR info line: 707 360-7060

All checks should be made to ≥Permaculture First Responder≤  A separate form should be completed for each registrant.

-PLEASE TYPE or PRINT CLEARLY-

Name________________________________________________________

Affiliation/Organization_______________________________

Address______________________________________________________

City _______________ State ______ Zip Code ________

Phone __________________

Email _______________________________________

Website__________________________________________________

Work Exchange : We are attempting to make this course as affordable as possible, so we can only offer a limited number of scholarships and work exchange positions. Please note work exchange will not be considered without a written letter of request and a $50 deposit.

Are you in need of Work Exchange if it becomes available? __________

*Please write and submit a one-page letter telling us about your family background and your needs and reasons for requesting financial support. Please outline your availability prior the course and your skills.

Fee includes onsite camping, organic food, a course reader and other course materials.  Do you have special food or accommodation needs we should know about? 

Registration Fee

Please send a check or money order made payable to "Permaculture First Responder": Payment Plans are available please inquire if needed.

Please indicate which course you would like to register for.

__Intro weekend Oct. 13-15, 2006                                                      $125

__Water Management Course December 9 &10th                        $100

__Full design Course Feb 2007                                                           $750

    *** Sign up for all three for $850 ***

                                                                  Sub Total            $_________                                               

Deposit $50.00 Due with Application                                           $_________ 

Please make a donation and invest

 In a scholarship for another student                                         $_________

 Total amount Included                                                                    $_________

You and Your Interests (optional) To help us better craft the course around the unique participants and to help you set your course intentions please take some time and answer the following questions. Think of this as the beginning of the assessment phase in the course design. Use additional paper as necessary. Thank you!

How, where and from whom did you hear about this course?

Why do you want to take this course?

What do you hope to get out of it?

How do you see yourself applying what you learn?

Tell us a little more about yourself, anything you'd like us to know.