Application Form

Application Form

Before completing this form, please read through our Field Course Policies and Procedures.

After application submission, we will review your application and inform you of your status within one week.

An initial payment of $200 must be made within 2 weeks of program acceptance. Your program space will not be reserved until this payment has been received. Full program payment is due by April 4th. Further details on payment options and dates will be sent with program acceptance. Acceptance is contingent upon completion of a diver medical questionnaire.

Name *

Date of birth *

Month

Day

Year

Email *

Phone *

Mailing address *

City *

State *

Zip Code *

How did you hear about this opportunity? *

College/University Attended (Attending) *

Area of Study *

Overall GPA *

Graduation Date *

Dive Certification Level and Year of Certification *

Total # of Logged Open Water Dives *

In what areas/regions have you been diving? Salt or fresh water? *

How will this opportunity impact and help you achieve your education and/or career goals? *

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