Puzzle Permaculture Presentation Booking Form
* Required
Your Name:
*
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Organization or School name:
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Phone number:
*
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Email:
*
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Street address of presentation:
*
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City
*
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Postal Code
*
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Quadrant of city
(Applicable only in Calgary)
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If the billing address is different from the address above, please type it here:
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Program you are most interested in booking:
*
Waste in Our World (grades 4-6)
Garden Design Challenge (grades 2+)
Interactions and Ecosystems Half Day program (grade 7)
Sustainable Food For Thought (grades 7-12)
Simply Permaculture for Adults / Corporate Lunch & Learn
Making classroom connections (grade 1-4)
Other:
Required
Participant information:
*
Grade 1-2
Grade 3-4
Grade 5-6
Grade 7-9
Grade 10-11
Grade 12
Adult
Other:
Required
Number of participants:
*
1-10
11-20
21-30
31-40
Other:
Best days & times for the presentation:
*
Please check all that apply
Wednesday morning
Wednesday afternoon
Thursday morning
Thursday afternoon
Other:
Required
Please check which item(s) you have access to the day of our presentation:
*
LCD computer projector
Smartboard
Required
What is your familiarity with permaculture?
*
never heard of it
heard of it but want to know more
taken an introductory class or read up on it
completed a permaculture design certificate
Other:
Required
How did you hear about Puzzle Permaculture?
Just so we know who to thank!
Your answer
Additional Information that you would like us to know:
(ie. have the students been learning about permaculture or gardening, if you have a school garden or natural area, special needs of students...
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