High School PDC Registration – Boulder Permaculture

Name

Email Address

Phone

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

What is the best way to get in touch with you?PhoneText MessageEmail

Emergency Contact Name

Phone Number

Why do you want to take a permaculture design course?

What do you hope to get out of this course?

Are you comfortable being outside and active in varying weather conditions?

Are you able to self-transport to and from various sites in Boulder County?

Do you have any dietary restrictions?

Graduation Year

Anything else you would like to share?

Payment PreferencePay in FullArrange Payment PlanApply for ScholarshipPayment completes the registration process. If you would like to make a complete or partial payment now, please do so using the link below. We will contact you to arrange a payment plan for the remainder of the payment. If you would like to apply for a scholarship, please click 'Pay Later' and fill out the separate application.