Bermuda Marine and Island Ecology Summer 2017 Course Application
Space is limited. Acceptance is at the discretion of the instructor. Please submit your application and deposit no later than December 12, 2016.
Date of Birth*
You must be at least 14.9 years old as of June 2017 to participate.
Grade you will complete this year*
Why are you interested in taking this course? *
Please explain your answer thoroughly. Type your answer here.
To be answered by student.
Parent/Guardian's Full Name*
Parent Full Name*
By checking this box, you are agreeing that your above typed name represents your signature.*
Please send a confirmation email to the address below*:
Please provide an email address where we can send a link to your current form.
Email Address :