Permaculture Design Course Registration
Please register for your 12 month course by filling the form below. The information you give will be used solely for the administration of the course. You will be able to unsubscribe from any emails you may receive. For details of the course go to https://www.permakai.nz/pdc/
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City/Town/Region
State / Province
Postal / Zip Code
E-mail
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Do you have any permaculture experience, or other relevant experience? (Experience is not required, it just helps us plan the course)
Is there anything you would like us to be aware of at this stage (e.g. accessibility requirements, health conditions, pronouns etc)?
Do you consent to being photographed? We may use the images and videos for social media and to promote future courses?
*
Yes
No, I'd prefer not
Registering as
Individual
Group
Please enter size of group
We will contact you for details
Todays date
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Day
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Month
Year
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Individual
In Full amount
Or First Installment amount
I prefer to pay:
online (a credit card form will appear)
bank transfer
Bank transfer to Account 38-9020-0790805-00, ref: PDC - In Full / First Installment
Online Payment by STRIPE
I want to pay
In one go
By installment
Calculated amount 1
Calculated amount 2
Your credit card will be charged
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Expiration Month
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July
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December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
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2033
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2045
Expiration Year
Thank you for registering, if you have any questions or comments please mention them here or email pdc@permakai.nz
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