Registration Form session 1 ~ May 19-23, 2023

When

Friday, May 19, 2023 at 12:00 PM PDT
-to-
Monday, May 22, 2023 at 4:00 PM PDT

Where

Black Oak Ranch
50350 Hwy 101
Laytonville, CA 95454

Contact

Terri Tall Tree & Gwen River Song
ncwhs@monitor.net
707-824-1429

Download the Work Exchange Application

Download the Scholarship Application

33nd Annual
Northern California Women's Herbal Symposium
ncwhs@monitor.net 707-824-1429

Session 1: May 19-22, 2023

Scholarship spaces are full, waitlist only.

sess 1-2023 Registration (#23)

*Required Information for Session 1

First Name

Last Name

Confirm Email

Phone/Mobile

Address Line 1

City

State

Zip Code

Use a separate registration form for additional adults.

________________________________________________________________________

Meal Choice

Regular Vegetarian

Vegan

Gluten Free

Is it ok to include you on the roster?

Yes

Interested in carpooling?
Check out the Ride Sharing link under the "general Info" button on the website.

Do you plan to sell at the marketplace, your own handmade goods only? By donation, suggested donation 10% of sales.

Yes

List all marketplace items for sale, registrants own handmade goods only.

________________________________________________________________________

Registering children or young women to attend with you?

Yes

In this section, please list the details for each additional child or young woman in your group.

Add A First

yes

First Name

Last Name of Responsible Adult

Age of Child or Young Woman

Meal Choice

Regular Vegetarian

Vegan

Gluten Free

Add A Second

yes

First Name

Last Name of Responsible Adult

Age of Child or Young Woman

Meal Choice

Regular Vegetarian

Vegan

Gluten Free

Add A Third

yes

First Name

Last Name of Responsible Adult

Age of Child or Young Woman

Meal Choice

Regular Vegetarian

Vegan

Gluten Free

Add A Fourth

yes

First Name

Last Name of Responsible Adult

Age of Child or Young Woman

Meal Choice

Regular Vegetarian

Vegan

Gluten Free

Add A Fifth

yes

First Name

Last Name of Responsible Adult

Age of Child or Young Woman

Meal Choice

Regular Vegetarian

Vegan

Gluten Free

Add A Sixth

yes

First Name

Last Name of Responsible Adult

Age of Child or Young Woman

Meal Choice

Regular Vegetarian

Vegan

Gluten Free

Add A Seventh

yes

First Name

Last Name of Responsible Adult

Age of Child or Young Woman

Meal Choice

Regular Vegetarian

Vegan

Gluten Free

________________________________________________________________________

Fees

Select from the following fees for yourself and each person in your group.
Be sure to fill out the section on registering others above, if you select fees for children or young women.

If you are a teacher, staff or trade do not select a fee. Enter your code at checkout.

REGULAR sliding scale 1

Fee: $490.00

Quantity

REGULAR sliding scale 2

Fee: $525.00

Quantity

REGULAR sliding scale 3

Fee: $560.00

Quantity

REGULAR sliding scale 4

Fee: $600.00

Quantity

CRONE discount age 60+, if needed sliding scale 1

Fee: $350.00

Quantity

CRONE discount age 60+, if needed sliding scale 2

Price: $400.00

Quantity

YOUNG WOMAN DISCOUNT age 12-21 ss1

Price: $180.00

Quantity

YOUNG WOMAN DISCOUNT age 12-21 ss2

Price: $200.00

Quantity

Age 3-11 years ~ sliding scale 1

Fee: $60.00

Quantity

Age 3-11 years ~ sliding scale 2

Fee: $80.00

Quantity

Age 3-11 years ~ sliding scale 3

Price: $100.00

Quantity

Age 0-3 years, no fee

Price: $0.00

Quantity

I would like to apply for Work Exchange

yes

Work Exchange~APPLICATION REQUIRED

Price: $150.00

Quantity

Please add me to the waitlist for scholarship

yes

Scholarship~APPLICATION REQUIRED, full ~ waitlist only

Fee: $0.00

Please add me to the waitlist for Women of Color Scholarship

yes

Woman of Color Scholarship, full ~ waitlist only

Fee: $0.00

Proceedings of The Conference

This is our womyn's herbal words. This is a collection of hand-outs and articles from the classes of this session, bound together in a soft cover spiral-back book. Pick up your pre-ordered book when you check in on the first day. They will also be available for sale there for $25.00

Proceedings

Price: $20.00

Quantity

________________________________________________________________________

No payment items has been selected yet

Checkout

Credit Card

Check or Money Order within 5 days

I have a code

Select this option if you are on a waitlist for scholarship

Make check payable to:
NCWHS
PO Box 28
Graton, CA 95444

Be sure to fill in and apply code to receive full discount

Apply Code

SelectOne

Teacher

Staff

Trade

Enter your total to calculate the credit card fee.

Enter your total here, only numbers (example: 490)

Credit Card Fee

Pay with Credit Card

Refresh the page to register additional adults