ECOLOGY ACTION

5798 Ridgewood Road, Willits CA 95490-9730 Phone: (707) 459-0150 Fax: (707) 459-5409

GROW BIOINTENSIVESM SUSTAINABLE MINI-FARMING

Three-Day Workshop Nov. 7-9, 2008 Willits, California WORKSHOP REGISTRATION
This form should be mailed or faxed to us at the above address or number. Name ________________________________ Phone: (_____)______________ (_____)______________ Fax: (_____)______________ E-mail: ____________________

Address ________________________________ ________________________________ ________________________________

How did you find out about this workshop? Bountiful Gardens catalog Word of mouth Newspaper or other publication (Name: ____________________________) Announcement on bulletin board (Where? ________________________________) Other (Specify: _____________________________________________________) EXPERIENCE: How would you rate your experience with Biointensive gardening? Just beginning Fairly basic (1-2 yrs) Moderate (3-5 yrs) Skilled (more than 5 yrs)

LANGUAGE: If English is not your native language, specify your native language: __________ and rate your English language ability on a scale of 10 (fluent) to 1 (can barely manage): ___ Listening ___ Speaking ___ Reading ___ Writing BIOGRAPHY: On a separate piece of paper, please write a brief autobiography (about 150 words), including how you first found out about GROW BIOINTENSIVE, how you intend to use the information you learn, and how you intend to be living and using these techniques 10 years from now. Also, briefly describe your current garden: the size of your growing area; what percent of that area is double-dug; the crops you grow for compost, food, and/or income. This biography (possibly edited for space considerations) will be included in the workshop program to facilitate networking among participants. Supplemental information may be shared with us, if desired. LUNCH: (We are not able to accomodate food recipes for allergies, such as nuts and wheat.) (Choose one) I prefer vegetarian vegan meals. I will bring my own food. (continued on page 2)
E.A. 3-Day Workshop, Reg. Form12/3/08p. 1

COSTS: Workshop Fee (including 3 lunches and networking dinner): $350 if received at least one month in ahead $400 if received less than one month in ahead $20 each for extra guests at the networking dinner MEMBERSHIP: I would like to help further Ecology Action's education work around the world. I have included my tax-deductible donation for membership (which includes a subscription to the Ecology Action Newsletter which announces other E.A. training opportunities): $25 Basic $40 Supporting Member $60 Family Member $100 Sustaining Member $100 Members may deduct 10% from the workshop fee. METHOD OF PAYMENT: I prefer to pay by: Check (Payable to Ecology Action) Credit card ( Visa MasterCard ) Card No. ____________________________________ Expiration ____/____ Signature _______________

PAYMENT: WORKSHOP FEE $350 / $400 Workshop Manual Ecology Action Membership (see above) Guest(s) for Networking Dinner ($20 ea.) ___________ 30.00 ___________ ___________ TOTAL ___________

Remember to order your publications from Bountiful Gardens and do the reading before you come, preferably at least two weeks before the workshop!

E.A. 3-Day Workshop, Reg. Form12/4/07p. 2