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APT ( Applied Permaculture Training)
Application Form
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Which Training Dates Are You Applying For?
Name And Surname
Email
Contact Number
Physical Address
Date of Birth
MM
/
DD
/
YYYY
ID/Passport/Birth Certificate number
Nationality
Apartheid Ethnicity Classification
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Biological Sex
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First Language
Other Languages Spoken
Disability and Medical Conditions
Physical, Mental Health, Other
Highest Educational Qualification (Grade)
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Other Qualifications
Next of kin name
In case of emergencies
Next of kin contact number
In case of emergencies
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?
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?
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A vegetarian breakfast and lunch is provided on the course. Do you have any dietary requirements / restrictions / allergies?
Have you been involved in any community / environmental / social justice work? Please specify
What specific topics are you hoping to learn about?
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
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Full name and surname as electronic signature
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