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APT ( Applied Permaculture Training)
Application Form
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Which Training Dates Are You Applying For?
17 July - 11 Aug 23
28 Aug - 22 Sep 23
Other:
Name And Surname
Your answer
Email
Your answer
Contact Number
Your answer
Physical Address
Your answer
Date of Birth
MM
/
DD
/
YYYY
ID/Passport/Birth Certificate number
Your answer
Nationality
Your answer
Apartheid Ethnicity Classification
Black
Coloured
Indian
White
Other:
Clear selection
Biological Sex
Female
Male
Other:
Clear selection
First Language
Your answer
Other Languages Spoken
Your answer
Disability and Medical Conditions
Physical, Mental Health, Other
Your answer
Highest Educational Qualification (Grade)
8
9
10
11
12
Clear selection
Other Qualifications
Your answer
Next of kin name
In case of emergencies
Your answer
Next of kin contact number
In case of emergencies
Your answer
Do you commit to attending class at our venue in Mitchells Plain from 8:30am to 4:00pm, Monday to Friday, for the duration of the course?
Yes
No
Clear selection
If you are not previously disadvantaged and therefore do not qualify for a course bursary, do you accept the course fee of R4,000?
Yes
No
I am previously disadvantaged and applying for the bursary
Clear selection
A vegetarian breakfast and lunch is provided on the course. Do you have any dietary requirements / restrictions / allergies?
Your answer
Have you been involved in any community / environmental / social justice work? Please specify
Your answer
What specific topics are you hoping to learn about?
Your answer
Do you have a criminal record? Arrest or conviction records should be disclosed but are not an absolute barrier to the course, decisions will be made on a case-by-case basis
yes
No
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Full name and surname as electronic signature
Your answer
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