Registration – PFG 2021 by Savanna Institute | Oct 5, 2021 Registration "*" indicates required fields Attendee name* First Last Preferred pronouns Attendee email* HiddenEmail Check Organization Address Street Address City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Early bird tickets* Standard $80.00 Farmer/Student $50.00 I cannot afford discounted pricing Suggested reduced rate Please fill in the amount you can afford to attend our Perennial Farm Gathering. Coupon If you have been given a coupon code for free access, enter it here.Help us track your free access! Apprenticeship Program Advisory Council / Board of Directors Other This helps us with grant reporting purposes!HiddenExtras Fibershed Workshop Cooking Demonstration with Beth Dooley Depending on the situation with Covid this fall, the fibershed workshop may be held in-person in Spring Green (details TBD) and/or virtually over Zoom.Would you like to sponsor, in part or full, someone who cannot afford the registration cost? Yes, I am happy to! No, not this year How much would you like to sponsor for scholarships? Total Credit CardCard Details Cardholder Name Optional questionsThe following questions help us with grant reporting, and our internal outreach evaluation. Thank you for answering!Is this your first time joining us for the Perennial Farm Gathering Yep! Nope! How do you identify your profession? (Check all that apply) Farmer Student Conservation/Ag professional (Forester, NRCS, etc) Landowner Researcher / Educator Other You marked other--how else do you identify professionally? Please let us know how you personally identify (check all that apply): American Indian or Alaska Native Asian Black or African American Native Hawaiian/Pacific Islander White Hispanic or Latine Other ethnicity Female Gender nonbinary Male Other gender LGBTQIIA+ Veteran Beginning farmer (<10 years) This data is only used in aggregate for grant reporting purposes. You marked other ethnicity--how else do you identify? You marked other--how do you identify your gender? How did you hear about our Perennial Farm Gathering? (Check all that apply) The Savanna Institute Website Email/Newsletter Workshop or field day Someone referred me Facebook Instagram YouTube Twitter Other Cool, how did you hear about the PFG?
