2023 Wild-foraged Mushroom Workshops Order Form

2023 Wild-foraged Mushroom Certification Workshop Order Form
Complete the required form below to register for:
- an in-person, Wild-foraged Mushroom Certification Workshop
- non-certification attendance
- recertification, reschedule (already paid) and retest (when applicable)
Please make sure your mailing address is accurate to receive curriculum materials!
- All full-certification registrants receive digital and hardcopy versions of the workbook and study flashcards.
- All people registering for the non-certified option receive digital and hardcopy versions of the workbook.
- For registrations whose curriculum material cannot be mailed, the materials will be available for pick-up at the workshop location on the day of the workshop.
Curriculum is mailed out via United States Postal Service ONLY if registration is completed 2 weeks prior to a scheduled workshop date.

For people registering for full-certification, please make sure the "Attendee Name" is correct as this is how it appears on the MDARD certificate.

If you have any questions or have not received your "Welcome Letter" and digital study materials within 72 hours of registration, please email mamimycology@gmail.com.

Thank you for your interest in the Wild-foraged Mushroom Certification Program!
Buyers Name*

First NameLast Name
Attendee Name *

First NameLast Name
Attendee Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County*
What County do you live in?
Attendee E-mail*
example@example.com
Attendee Phone Number

Area CodePhone Number
Birthdate*

MonthDayYear
Date
Choose a location/date:*

March 18, 2023 - Michigan State UniversityApril 15, 2023 - Jackson/Chelsea Area (Site pending)April 29, 2023 - Hanson Hills Recreational Area, GraylingJuly (late)/August - Upper Peninsula (Date and location TBD)October 1, 2023 - Proud Lake Recreation Area, Commerce Township
Choose a Certified or Non-Certified Workshop.

*After submission, you will be forwarded to PayPal for payment. Registration will not be accepted until payment has been received.
Workshop Type*
prevnext( X )
Certified$175.00
This option is for an attendee to attend the Wild-foraged Mushroom workshop and take the exam; MDARD issues certificates to those people attaining 80% or higher on the exam. If needed, 2 exam attempts are included in this price.

Non-Certified$85.00
This option is for an attendee to attend the Wild-foraged Mushroom workshop; the exam is not included.

Morel Certificate Holder$100.00
This option is for people who are currently certified to only sell Morchella species.

Pre-paid, gift certificate $ Free
*Please enter your gift certificate number in the box below.

Recertification (Exam Only)*$75.00
*Please enter your certification number below.

Reschedule $ Free
*This option is for people who were previously registered (and paid) to attend a workshop but could not attend.

Retest #1 $ Free
*This free option is for people who previously attended a Full-certification workshop but did not attain 80% or higher on the exam.

Retest #2 $ Free
*This free option is for people who previously attended a Full-certification workshop but did not attain 80% or higher on the exam.

Total $0.00
*Certification Number
*Gift certificate number
MAMI will try to accommodate special dietary needs for lunches; please choose any special dietary requirements you may have.
NEW! Optional: Check all of the boxes to the right which apply to have your information appear publicly on the MAMI website. (This helps people network and conveniently find certified mushroom sellers)

Name/Business NameAddressEmail AddressPhone NumberWebsite Address (Enter site address below)
Website Address
Enter the message as it's shown*
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2023 Wild-foraged Mushroom Certification Workshop Order Form