EARTH ACTIVIST TRAINING REGISTRATION FORM

Earth Activist Training
Registration Form

January 5 - 19, 2008
at Black Mountain Preserve, Cazadero, California, USA

To Register:

Copy and paste this form into an email, send to earthactivisttraining(at)gmail.com, and mail your check for deposit or full course amount with any additional information.

Make checks payable to Earth Activist Training & mail to:

Earth Activist Training
PO Box 251
Sierraville CA 96126

Name_______________________________________________________________

Address_____________________________________________________________

___________________________________________________________________

City________________________________________________________________ State/Province _______________________ Zip/Mail Code ____________________

Country, if not US ______________________

Contact Phone _______________________________________________________

Emergency Phone ___________________________________________________________________

E-mail ______________________________________________________________

(Our contact with you will be through email unless you specifically mention that this does not work for you)

Tuition for this EAT Course includes all standard meals, tent camping accommodations, classes, workshops, rituals, and course materials for the entire course.

Course Pricing: Please indicate how much you plan to pay in total, using our income-based sliding scale and get us your deposit (the deposit is one-half of the sliding scale price that you select - once we receive your deposit we can consider you registered)

______$1700, if you have abundance in the form of money
______$1500, if you are working and solvent
______$1200, if you are scraping by
______ somewhere in between or over $1700-1200: $__________

Work Trade: We offer a limited amount of work trade positions per course. Work trade students are required to:

pay half or more, of one of the above sliding scale prices
pay a deposit (the deposit is one-half of the dollar amount you agree to pay towards your tuition - once we receive your deposit we can consider you registered)
be willing to come early, stay late, and be assigned to one of our work trade positions
submit a work trade application and personal letter letting us know what your specific skills are and why you want to be considered for work trade

Work trade applicants are generally approved towards the end of the registration period. You will need to be flexible on your travel and be able to make last minute travel adjustments and arrangements.

______ You're applying for work-trade.

If accepted, please indicate how much you could pay of your own tuition: $__________ (at least one half of one of the above sliding scale tuition prices. Your deposit will be one half of that price and must be sent in with this registration form and your personal letter).

Optional:

______ Additional Donation to scholarship fund, to help others attend

No-Refund Policy:

Deposits are absolutely nonrefundable if you cancel for any reason. However, deposits may be transferable to a future session. (In the unlikely event that we must cancel the course, all monies paid, including your deposit, will be refunded.) Full tuition payment is required by the registration deadline, or you may forfeit your reserved spot.

I have read and understood the NO-REFUND policy.

______________________________________________________________

(signature required—if registering by email, sign electronically by putting slash marks on either side of name.
Example: /Glitter Mudster/)

Transportation

See "Transportation" section of your confirmation packet before you make travel plans and buy tickets — there is a limited time window for any flights, trains, or buses.

To facilitate your transportation, please let us know...

____I am interested in carpooling and would like contact info for other registrants in my area. I hope to GET a ride from____________(area) and/or I can OFFER a ride to____(number) people from____________.

Note: EAT cannot guarantee that there will be carpool rides for everyone who wants one.

____ I am flying into nearest city and will need transportation to site.

Food Needs:

EAT bases its food budget based on your answer to the following, and allots specific amounts of meat, vegetarian and vegan options based upon the information that all of the students provide us. Please note that we cannot budget for folks who wish to eat meat occasionally during the course, and we cannot change our food order after it has been placed, so while the food is delicious and enticing, please do not change your mind on the options below after the course has started, AND please be specific about what food we should order for you.

____ I eat meat and require it in my diet
____ I am a vegetarian and will not be eating meat
____ I am a vegan

Special Food Needs: If you have a severe, life-threatening food allergy (such as peanuts), be sure we know!
_____________________________________________________________________
_____________________________________________________________________

Physical Special Needs:

If you have any physical special needs or are differently abled, please let us know:
________________________________________________________________________
________________________________________________________________________

I heard about the Earth Activist Training from:

____ Word of mouth (please provide name of group or friend who told you about us) _________________________________________________________
____ Online at ___________________________________________ (did you click-thru the Google ad?)
____ Advertisement in ____________________________________
____ Flyer received at ___________________________________
____ Starhawk's book "Earth Path"
____ At a talk given by________________ at location _______________
____ Other _________________________________________________

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