organizing experiential learning events for sustainable and regenerative design

Course Registration

After sending in your registration/application through this online form you will be forwarded to a page confirming your submission. You may also email the same information requested on the form. You will receive a brief confirmation message from us within days to acknowledge that your information has been received. If you do not hear from us within a week please email us to inquire and try using the form again. You may also download this application as a pdf or doc file.

If a course has a fee or tuition it will be listed on the event description and on our payments and donations page. For the Permaculture Design Certification course, a $400 deposit will reserve your spot. Deposits are non-refundable.

You can make checks payable to FINGER LAKES PERMACULTURE INSTITUTE. The deposit check can be mailed to: P.O. Box 54, Ithaca, NY 14851. Credit card and PayPal payments are also accepted.

Please fill out a different application for the summer apprenticeship.

*Enrolling in what program? If Mushroom Weekend, SATURDAY ONLY or ENTIRE WEEKEND? *Last Name: *First Name: *Address1: Address2: *City: *State *Zip code: *Primary phone number *Email address: Date of birth: NOTE: You are only required to answer the questions below if you are registering the Permaculture Design Certification course. Fill out a different application for the summer apprenticeship, not this one. 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.
You will be directed to our payments and donations page if your registration is transmitted successfully.