Radical.Care Reclaiming PDC Interest Form
Hello! Thanks for making your way here. Head to radical.care (copy paste radical-dot-care into your browser and tap enter) for more information. All teaching positions will be paid. All classes will be sliding scale. All class times will be listed in PST and prices in USD. Collaborations, equitable exchanges, and solidarity with other BIPOC organizations will be our sacred ground.
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Name *
Email address *
Phone number and time zone *
Preferred method of contact? *
Why are you interested in participating in the radical care pdc? *
Have you ever completed or attended a Permaculture Design Course before? *
What are you most interested in learning with us? *
Are you interested in teaching or sharing a permaculture or related skill with Radical Care participants? If so, thanks! Please tell us about your practice/experience/proposal. (Optional)
Do you have a website or link highlighting your work you'd like to share? If so please do (multiple links separated by commas).
How do you identify ethnically? (check all that apply) *
Required
What are your pronouns? *
Describe your gender
Do you identify as LGBTQIA+? *
Required
Which element do you feel you embody or reflect the energy of most in your life? *
Do you know whose land you're on? If so, please tell us. *
What is your favorite nonfiction book (or top 3) and why? (Optional)
Have you ever participated in a protest, march, demonstration, occupation, online solidarity action, boycott, or other political event?
Clear selection
Have you ever participated in direct reparations before? *
Do you have any disabilities or conditions we should know about that might impact your experience of the program? Please list in as much detail as you fee necessary. *
Please tell us about your experience level and comfortability with wilderness, hiking, and/or camping. *
Do you swim?
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Do you currently or have you ever gardened or grown your own food before? *
Do you have a spiritual, meditative, creative, or other reflective practice?
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Birthdate *
MM
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DD
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YYYY
Do you have children under the age of 18 years old that you would like to share this course experience with? *
If you ARE interested in sharing this course with children how old are they? (Optional)
Do you prefer virtual or in person (outdoor) sessions? class size will be limited regardless, and masks will be required. *
Where are you located? *
If outside California where are you located? (Optional)
When are you available to attend classes (there will be both virtual and in person offering options available) ? *
Generally, what time of day and days of the week do you expect will work best for you to attend classes? Check all that apply. *
Required
How did you hear about Radical Care? *
Do you have any questions for us?
Is there anything else we should know about you or other information you'd like to share?
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