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.

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)

PLEASE CHOOSE ONE OF THE BELOW OPTIONS

____ Are you a paying student? If so, once we receive your registraion form AND your deposit we can consider your registered.

____ Are you applying for work trade? If so, please see the Work Trade section below.

____ Are you applying for a full scholarship? If so, please see our Scholarship info on our web site and include your personal letter in the email with this registration form.

Tuition for this EAT Course includes all standard meals, 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: $__________

______ I'm also donating to the scholarship fund! _______ If so, THANK YOU!

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 - thank you for mailing in your deposit now, without it we cannot consider you for work trade. We will return your un-cashed check to you if for some reason you are not approved.)
  
•  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.

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. We also need your deposit mailed to us at this time. Without it we cannot consider you for work trade. We will return your un-cashed check to you if for some reason you are not approved.).

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

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.

EAT purchases food based on your answer to the following, and we require that you let us know which catagory you will be in during this course.

____ I am omnivorous (meat will be served 3 or so times per week)
____ I am a vegetarian
____ I am a vegan

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

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

Please let us know how you heard about Earth Activist Training. It means a lot to us to know if our advertising is working.

____ Word of mouth (please provide name of group or friend who told you about us, it really is important to us to thank people.)

_________________________________________________________

____ Online at ___________________________________________

____ Did you click-thru a Google ad?

____ Advertisement in ____________________________________

____ Flyer received at ___________________________________

____ Starhawk's book (which one?) __________________

____ At a talk given by________________ at location _______________

____ Other _________________________________________________

____ I wouldn't be able to remember to save my life

 

THANKS! We are excited about meeting you!

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