Earth Activist Training: Winter 2018 Registration
Permaculture Design Certificate Course with Starhawk, Charles Williams, and Pandora Thomas
January 6th - 20th, 2018, Cazadero, CA, United States
Sliding scale $1800-$2300, limited Work-Trade and Diversity Scholarship positions available
Contact Information
First Name *
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Last Name *
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Email *
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Mailing/Street address *
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City *
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State (Province/Region - Non U.S.) *
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Country *
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Zip Code *
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Home Phone *
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Cell Phone *
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Referral information *
Where did you hear about this course? From an event or website? Please be specific.
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Emergency Contact and Medical Information
All information will be kept confidential. Please email us at info@earthactivisttraining.org if you have any questions.
Emergency Contact Name *
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Emergency Contact Phone Number *
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Physical Special Needs
If you have any physical special needs or are differently abled, please let us know, and indicate any needs here.
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Mental Health Needs
If you have any mental health needs that might affect your participation in the course, please let us know.
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Rideshare Program
Our rideshare program allows our registrants to connect with each other to give and receive rides. Details will be provided by those who offer or request rides in the section below. Ride coordination is organized within the two weeks leading up to the course.
Carpool/transit info *
To help us facilitate transportation to and from the course, please let us know how you will be getting here:
Ride Offer *
Can you offer a ride to fellow course participants? (more details in following questions)
Ride Offer details
Please let us know where you are driving from and how many people (and their bags) you can take in your vehicle.
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Ride Needed details
If you are flying in and need to arrange transportation from the airport, please indicate that here as well as your flight, train, or bus arrival information. Often we can arrange rides from near Oakland or San Francisco airports, but if that is not possible we will arrange a pickup from the Santa Rosa transit hub which is served by Airport Express (http://airportexpressinc.com/).
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Accommodations
Accommodations *
The accommodations for this course are shared, dorm style rooms, please bring your own linens or cash/check to rent bedding from Black Mountain for $5/day ($70 total for two weeks). For an additional cost, we have a limited number of single and double rooms available for students. Students with health and accessibility needs have priority to rooms. If you are interested, please select one of the "Private Room" options below. If you have any questions about accommodations, please contact us at info@earthactivisttraining.org.
Food Information
EAT bases its food budget based on your answer to the following, and we shop for specific amounts of meat, vegetarian and vegan options based upon the information that students provide us. We can easily accommodate common food allergens, please indicate below, but please note that we cannot accommodate for folks with very specific dietary requests, such as raw and live foods. We also cannot change our food order after it has been placed. So while the food is delicious and enticing, please do not change your mind on the options below after the course has started, and please choose an option now. If you have any questions about your specific food needs, please contact us at info@earthactivisttraining.org and we can create a solution together.
What is your dietary preference? *
Please check any food allergies that you have:
Special Food Needs
If you have a severe, life-threatening food allergy (such as peanuts), be sure we know! Please indicate any needs or food allergies here. If you answered "Other" above, please explain here:
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Registration Completion
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