* = Required fields

Basic Information

Your Name*

Organization* (if none, put personal)

Street/road and number*

Town/city*

Province/state*

Country*

Postal address

Phone - Landline (with codes)*

Phone - Cell (with codes)

Fax

Email*

Website

Permaculture Training and/or Experience

Course 1 Date Trainer Location

Course 2 Date Trainer Location

Course 3 Date Trainer Location

Course 4 Date Trainer Location

Other Sustainable Agriculture Courses or Relevant Experience

How long have you been practicing Permaculture or sustainable agriculture?*
Never, would like to start1 - 12 months2 years3 years4 years5 years6 - 10 years11 - 15 years16 - 20 years21 - 30 years31 - 40 yearsMore than 40 years

Do you belong to any similar networks or associations? (i.e. PELUM) Please list here

Do you have specific areas of interest or focus or expertise, such as schools permaculture, sustainable agriculture training, eco-villages, ethical finance, consultation?

Tell us about your project: how many schools/households/communities you work with, how long implementation has been underway, how much land area is under sustainable management, details of your approach and any other information to help others know more about you and what you are doing.

Are you involved with a training or education centre? If so, what is the name and location of the centre, and what types of workshops/courses do you offer?

Any additional information that you would like posted on the Plan Africa website? (This is a great place to post your organizational vision, and to state your interests for this network, and the resources you seek to better realize your aims.)

Consent:

I give Plan Africa permission to use this information and make it available to other members of the Plan Africa group via the website and for the Plan Africa network map.