Permaculture Institute of Eastern Ontario (PIEO)

2015 COURSE REGISTRATION

To register and reserve your place in a course, please submit the course fee along with your completed registration form.

Please submit ALL pages of this document.

Name:

Email:Phone:

Address:City:Postal Code:

Emergency Contact Name:

Emergency Contact Phone:

In the table below, please check the course option for which you are registering. The course fee includes HST (#803398650).

Course Option / Submit the FULL course fee along with your registration form / Please check X the option(s) you are choosing
Permaculture 101
Saturday, August 29, 1pm to 4pm
Perth, ON / sliding scale $30 to $40
Edible Forest Garden
Saturday, September 26, 9:30am to 5:30pm
Perth, ON / sliding scale $70 to $90
Living by Design: Eco-Logical Design for Your Life & Small Business
Saturday, November 7, 9:30am to 5:30pm
Perth, ON / sliding scale $70 to $90

Please note that meals and accommodations are NOT included.

Please indicate how you plan to pay:

Email Interac

Cheque

TO SUBMIT YOUR REGISTRATION & COURSE FEE

Please submit BOTH the course fee and your registration form to reserve your place in a course.

Registration Form:

  • Please submit ALL pages of this document.
  • You may email your form to or snail mail it to:

Bonita Ford

28 Church St.
Perth, ON K7H 2A3

Course Fee:

  • The quickest way to submit your course fee is by email Interac. Email Interac is offered by most major banks:
  • Cheques can also be written to “Bonita Ford” and mailed to the address above.
  • About a week before the course, we will send you a confirmation email with details about dates/start times, location, meals, transportation, clothing and more.

CANCELLATION AGREEMENT

Out of consideration for the course planners and other potential students:

  • More than 3 weeks before the start of the course:
  • If you cancel your registration, a cancellation fee (equal to 25% of the course fee that you paid) will be charged and the balance refunded.
  • Less than 3 weeks before the start of the course:
  • If you cancel your registration, a cancellation fee (equal to 50% of the course fee that you paid) will be charged and the balance refunded.
  • We do not offer a refund once you begin the course.
  • In the event that we cancel the course, we will offer you the choice of a refund or a credit for another course.

ABOUT YOU

To help us prepare the course, we'd like to know a little bit about you. Please take a few minutes to answer the following questions.

What are you hoping to get or learn from this course?

What is your experience with permaculture?

How did you hear or find out about our course?

Is there anything else you would like to share with us?

Do you have any limitations, restrictions, medical conditions or serious allergies that you want us to be aware of? If so, please describe them.

I (your name) ______agree to the Cancellation Agreement and the course fees described above.

Date: ______

Please submit ALL PAGES of this document.

Permaculture Institute of Eastern Ontario

* * 613-267-1926