PDC Apply — PUNTA MONA

Permaculture Design Course

January 7th - 21st 2022

Subject

First Name

Last Name

Email Address

Birthdate

YYYY

Gender

Hometown

Current Location

Housing Preference

Incudes food, lodging, workshop

Why do you want to be a part of this experience?

What is your level of experience being in nature and/or off-the grid?

Do you have any applicable experience, trainings, certificates, etc?

Best Personal Qualities & Challenging Personal Qualities

Allergies and Dietary Preferences:

Existing Medical Conditions:

And how we can support you.

Emergency Contact Name

Relationship

Phone Number (country & area code)

How did you hear about Punta Mona and this course?

Please add me to your Punta Mona newsletter!

Yes!