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Ecology Action teaches people worldwide to better feed themselves while building and preserving the soil and conserving resources.


Enrollment Form

Latin American Soil, Food, & People Conference



Name:

Current position/job title:

Passport # : Email:

Home Address:

City:

State: Zip Code: Country:

Employer's Name:

Employer's Address :

City:

State: Zip Code: Country:
Daytime telephone:


Evening telephone :

Email:

Website:
Language Preference:    English        Spanish
How do you expect to use the information gained at this/these event(s)? Please write a short mini-biographical paragraph of 50 to 150 words about yourself, your work and your goals.
       
I want to attend both the 3-Day Conference
and the 6-Day Workshop.
U.S. $650
12 days, including the Registration Day,
2-Day Break and the 3-Day Conference
I want to attend the 6-Day Workshop only.
U.S. $450
6 days, including the Registration Day
   
I want to attend the 3-Day Conference only.
U.S. $250
4 days, including the Registration Day
and the 3-Day Conferencep
Please send me information about the
2-Day Economic Mini-Farming Workshop
 
Payment Information:
Certified bank check in U.S. dollars or Mastercard, Visa, Am Ex, or Discover Card

Card #: 

FOR MORE INFORMATION:

Ecology Action
5798 Ridgewood Road
Willits, CA
95490-9730
USA

Phone:
(707) 459-0150

FAX:
(707) 459-5409

Email:
bountiful@sonic.net

Website:
www.growbiointensive.org

Expiration date: 

Signature: 

Date: 


 



Ecology Action has been a small 501(c)(3) nonprofit organization since 1972.

©2006 Ecology Action.

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