Murujan PDC January 2012

Permaculture Design Course Registration

First Name *

Last Name *

Email Address *

Date of Birth *

Phone

Will you Require Over-night Accomodations On-site? *

Yes

No

Meal Options *

Please List any Medical Conidtions or Allergies You Have

How Did You Hear About this Course? *

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Payment Information is available here:

PAYMENT INFO

Remember to take a copy of the receipt and to please scan and email it to contact.murujan@gmail.com with the subject DEPOSIT RECEIPT. The remaining amount can be paid by cash or check before or on the first day of the course. We accept only Malaysian Currency or USD or British Pounds.

Attendance of this course is not guaranteed and Murujan Permaculture Design reserves the right to conduct background checks on all potential participants.