WORKSHOP REGISTRATION

This form should be mailed or faxed to us at the above address or number.

Name _______________________________	Phone:(_____)___________________
Address _____________________________	(_____)_______________________
	Fax:(_____)___________________
Email _________________________________

How did you find out about this workshop?

Word of mouth

Bountiful Gardens catalog

Newspaper or other publication (Name:__________________________)

Announcement on bulletin board (Where? _____________________________)

Other (Specify: _________________________________________________)

EXPERIENCE: How would you rate your experience with Biointensive gardening?

Just beginning Fairly basic (1-2 yrs) Moderate (3-5 yrs)  Skilled (more than 5 yrs)

LANGUAGE: If English is not your native language, specify your native language: ______________________________________________________________________________
    and rate your English language ability on a scale of 10 (fluent) to 1 (can barely manage):
                        ___ Listening     ___ Speaking      ___ Reading     ___ Writing

BIOGRAPHY: On a separate piece of paper, please write a brief biography (about 150 words), including how you first found out about Grow Biointensive, how you intend to use the information you learn, and how you intend to be living and using these techniques 10 years from now. Also, briefly describe your current garden: the size of your growing area; what percent of that area is double-dug; the crops you grow for compost, food, and/or income. This biography (possibly edited for space considerations) will be included in the workshop program to facilitate networking among participants. Supplemental information may be shared with us, if desired.

LUNCH:

(Choose one) I prefer    Vegetarian       Vegan       I will bring my own food
If you have any special food allergies, we recommend you bring your own food.

COSTS: Workshop Fee (Including three lunches and networking dinner):

• $350 if received at least one month in advance.
• $400 if received less than one month in advance.
• $20 for each extra guest at the networking dinner.
• Cost of Publications: $30.00 for the Workshop manual. For other publications, see Bountiful Gardens.

MEMBERSHIP: I would like to further help Ecology Action's education work around the world. I have included my tax-deductible donation for membership (which includes a subscription to the Ecology Action Newsletter, which announces other E.A. training opportunities):

$25  Basic $40  Supporting Member    $60  Family Member   

$100  Sustaining Member 

METHOD OF PAYMENT: I prefer to pay by:

Check (Payable to John Jeavons.)
Credit card ( Visa, MasterCard)
Card No. ______________________  Expiration ___/___  Signature __________________

PAYMENT:

WORKSHOP FEE $350 / $400	_________________________
Workshop Manual	$30.00
Ecology Action Membership (see above)	_________________________
Guest(s) for Networking Dinner ($20 ea.)	_________________________
TOTAL	_________________________

 

Remember to order your publications from Bountiful Gardens!