July 2024 PDC Course Registration
This is the registration form for the PDC course that will be held at Mainsprings' Kitongo Campus near Mwanza Tanzania from July 22nd- 31st, 2024. Please fill out this form to the best of your ability, if there are questions or concerns, please feel free to reach out by Email to Earnmovement@gmail.com.
Name
First Name
Last Name
Email
Info@mainsprings.org
Phone Number
Please enter a valid phone number.
Country of Residence
Ex. Tanzania
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Gender
Please Select
Male
Female
Individual or Organization
Please Select
Individual
Organization
Name of Organization (if applicable)
If attending on behalf of an Organization- How many people does your Organization reach?
Please Select
0-99
100-249
250-500
500+
How did you hear about the PDC Course?
Reasons for your interest in Permaculture?
Any Dietary restrictions?
Any medical conditions we should be aware of? (including allergies to medications)
Where is the closest Bus Station or Airport to you?
Please Upload your Passport Here:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
Should be Empty: