Eco-Homes Registration/Application Questionnaire
To apply for the Eco-Homes workshop, please fill out the questionnaire below. There are no specific pre-requisites of knowledge needed for the course, so please do not be concerned if you have little background in any or all subject areas. Your answers help us to understand what the average level and diversity of knowledge in the group will be. The information in the questionnaires helps us respond to the backgrounds and interests of the participants as best we can within the framework of the program and the requirements for the certificates. Concise responses to the questions are appreciated.
To mail, send the completed questionnaire to the Lost Valley address at the bottom of this page. To print this page, scroll to the bottom of this webpage and press the "Printer Friendly Version" button.
To email, copy this questionnaire out of this webpage into a word processor, add your answers and email them to epcp <at> lostvalley <dot> org.
In order for us to reserve a space for you in these programs, you will also need to provide a security deposit. Instructions for the security deposit are at the bottom of this questionnaire.
Registration for the 2008 Eco-Homes workshop August 11 -29. Sliding scale $875 - $1025.
Name _________________________Address _____________________City __________________
State _______ Zip_____________E-mail Address ________________________
Day phone _______________ Eve phone_______________Date of Birth ___________________
How did you hear about the course?
Do you currently own a home? Do you wish to build a home for yourself in the near future? Do you wish to build sustainable homes for other people?
On a scale of 1-10, with 1 being not at all interested, 5 being average interest, and 10 being very interested, please indicate your interest level in the following subjects (if you don’t know you can leave it blank):
Basic Home Construction:
Foundations__ framing___roofing___, wall structures and insulation___, home design and layout___, developing hands-on physical skills___, reading blueprints__, permits and codes___, conventional vs. natural building materials___, strawbale, straw/clay, cob___, primitive building___, other_______________________,
Appropriate Technologies:
Energy efficiency and renewable energy___, water catchment, greywater and composting toilets___, passive solar design___, solar thermal hot water___, photovoltaic solar power___, radiant heating___, high efficiency wood-burning stoves___, microhydro power___, wind power___, other_______________________
The Building Process:
Obtaining permits___, codes and inspections___, owner-bulder rights and responsibilities___, funding sources/opportunites___, legal and zoning issues___, permaculture design and relationship between home and environment___, co-housing, co-ops, community land trusts and ecovillages___, other_______________________
Occupation: If you are currently a student, please indicate which school/college, year and department.
What is your education level and experience in building (and specifically sustainable building)?
What is your education level and/or experience related to appropriate technology?
Any other area of expertise/knowledge:
Do you have specific goals for what you plan to do with what you learn here after the course?
Do you live in an urban, suburban or rural setting?
Community involvement and affiliations?
Are you okay with living in a rustic, rural intentional community for the period of the course?
Are you comfortable participating in hands-on projects?
Are you comfortable being in an environment where you will have the opportunity to look at and take responsibility for your own behavior patterns?
What challenges do you expect might come up for you?
Please list any health problems, special needs, addictions, food allergies or special food needs or other comments:
Payment
I have read the below and I am submitting a deposit which will go towards my course tuition, by (please check one):
a. __a check for $_____ is included in the envelope with this form.
b.__I will call in with a credit card number.
c. I will send in a check at the following time _____.
In order for us to reserve a space for you in the program, you will need to submit a $400 security deposit which will go towards your course tuition. The security deposit is not processed until you are accepted into the program. If you are not accepted into the program the deposit is not processed--the check is torn up or credit card number not processed and purged from our records. If you are accepted and then decide not to attend the program, $75 of your deposit is non-refundable from the time you are accepted and the remainder of the deposit is non-refundable after June 30th. The final payment is due by July 11th.
You can submit the deposit as soon as you submit the registration form, or after we confirm your acceptance, whichever you prefer. All payments by check should be sent to:
Lost Valley Educational Center
Attn: Events - EPCP Registration
P.O. Box #55
Dexter, OR 97431
Or to use a credit card, please call Lost Valley Events: (541) 937-3351 x 112
Thank you for your application.