Registration/Application Questionnaire
To apply for the Permaculture Design Course, 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.
Name:
Address:
E-mail:
How did you hear about the course?
Areas of interest related to Permaculture:
Areas if expertise/knowledge (any kind):
Occupation:
Do you live in an urban, suburban or rural setting?
Community involvement and affiliations:
Permaculture experience:
What type of:
a. information would you most like from this course?
b. hands-on experience would be helpful? i.e. tree planting, pond and building? other?
Are you comfortable in participating in hands-on projects?
Do you have experience in gardening?
What challenges do you expect might come up for you?
Other comments (please mention any allergies, injuries, etc. that may affect your participation in this course):
List any special interests so we can provide relevant resources such as books, catalogs, or web sites.