member.2010-09-09.8911530353 — Permaculture International Limited

PIL Registration Form

Please enter your registration details.

After you have submitted this form you will be asked to send payment to Permaculture Internation Limited. On receipt we will send you an email with log in details for the site.

User name (Required)

Enter a user name. Please use your full name as one lowercase word, for example 'janesmith'. No spaces or special characters. User names and passwords are case sensitive, make sure the capslock key is not enabled. This is the name used to log in.

First Name (Required)

Last Name (Required)

E-mail (Required)

Enter an email address. This is necessary in case the password is lost. We respect your privacy and will not give the address away to any third parties or expose it anywhere.

Phone1

Phone2

Street Address

Town or Suburb

Country (Required)

State or Province

Postcode or Zipcode

Type of Membership (Required)

Select applicable membership

$35 - Full membership (having completed a Permaculture Design Course - please provide PDC details below)
$25 - Associate membership (No PDC & all overseas members)

Permaculture Design Course Details

Those applying for Full Membership must give details of where, with who, and when you completed your PDC.

Sponsor a Member

Pay for someone else's membership

$30 - PIL to award to approved Permaculture applicants, graduates & NGOs in developing countries

Number of sponsorships

How many memberships would you like to sponsor (if any)?

PERMAFUND Donation

Amount in $AUD to donate to PERMAFUND [tax deductible fund for Australian residents to support PIL & PC projects globally]

Other details

Enter any other details or comments you'd like to add

Receipt?

Do you require a receipt to be sent to you?

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