Finger Lakes Permaculture Institute | a project of Cayuga Nature Center

REGISTER

FINGER LAKES PERMACULTURE INSTITUTE

Contact Information and Questionnaire

This information can also be printed, completed and mailed to Finger Lakes Permaculture Inst., PO Box 54, Ithaca, NY 14851 or emailed to as an attached document. Download the application in .pdf, .doc or .txt format.

A $25 - $50 deposit for classes and $200 deposit for the PDC will reserve your spot. Deposits are non-refundable.

You can make checks payable to CAYUGA NATURE CENTER or call 607-273-6260 to pay by credit card.

**TO SIGN UP FOR THE APPRENTICESHIP, DOWNLOAD THIS FORM
*Enrolling in what program? Other *Last Name: *First Name: *Address1: Address2: *City: *State *Zip code: *Primary phone number Secondary phone number: *Email address: Date of birth: **NOTE: YOU ARE ONLY REQUIRED TO ANSWER THESE QUESTIONS IF TAKING THE PERMACULTURE DESIGN CERTIFICATION COURSE
Please answer the following questions (so we can get to know you...) How did you learn about the course?
Briefly describe how your educational or personal journey has brought you to be interested in this course.
What skills/qualities/knowledge would you like to acquire through this course?
What skills or passions do you have that you would like to share with other students and instructors?
Especially if you are taking our certification course, you will be in an environment where you will have the opportunity to look at and take responsibility for your own behavior patterns. How committed are you to utilizing this opportunity?
Do you have any health problems, special needs or addictions?
How do you see your role in creating a sustainable world culture?
Is there anything else that you think we should know, or that you would like us to know about you?

You will be asked to sign the following waiver upon your arrival at the course or workshop, if you have not already mailed it in with your signature. Please read it:

"I understand the basic risks of activities associated with
workshops and will not hold the Finger Lakes Permaculture
Institute or any of the individuals responsible for ANY
decisions, actions, or accidents that result in damaged
goods or persons.

I take full responsibility for safe travel to and from
courses, for safe conduct in class and kitchen
settings, and for safe interactions with my fellow
students and instructors."

*Do you understand and agree with the above statement?
I agree and will sign this waiver.