Your Name

Phone

Email

Address

Tell us a bit about yourself...

What do you hope to learn in this course?

Emergency contact name and phone

Dietary preferences/restrictions

What is your previous experience with permaculture?

Why do you want to take this permaculture teacher training?

If you have children, are you interested in a youth program?
YesNoI don't have kids
Interested in Optional Electives outside of the course? If so, what topics would you like to explore?

How did you hear about this course?

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