Name: 

E-mail: 

Current Address:

Telephone: 

Fax: 

Dates you may be contacted at this address: 

Permanent Address: 

Telephone: 

Fax: 

Dates you may be contacted at this address: 

Age:

Sex:     Female     Male

Citizenship: 

If you are a U.S. citizen, can you be considered a minority applicant? This question pertains to scholarship awards. If you select "yes," we may require verification.

 Yes    No

University or Employer: 

Education Standing or Position: 

Are you a certified scuba diver?   Yes     No

Scuba certification and level: 

Date of last dive: 

Courses:

Number of courses you wish to attend: 

Check the box for each course you wish to apply for. Please note that some course dates overlap.

 Coral Reef Ecology: July 13 - August 2, 2008

 Microbial Oceanography: June 22 - July 12, 2008

In the following box, please preference your choices:
eg: 1. Coral Reef Ecology 2. Microbial Oceanography 

Please provide a statement of how the course will advance your education or research goals:
 

Is there anything else we need to know to judge your application fairly and completely?
 

Do you have need of a scholarship?  Yes     No

If you checked "yes," please provide a statement attesting to your needs and qualifications for a scholaship, and outlining your contributions to the cost of the course. Transportation costs must be borne by the course attendee. The "Scholarship Requested" should equal "Total Course Cost" minus "Student Contribution."

Total Course Costs (see Course Descriptions): 

Student Contribution: 

Scholarship Requested: 

Statement of Needs and Qualifications: Indicate here why you should be awarded a scholarship. Include academic merit, financial need, other support available to you, and any other information that you feel we should consider.
 

How did you hear about this BIOS course?
  BIOS web site
  Other web site. Please specify below.
  Professor
  Course flyer
  Other. Please specify below

Other web site or method:

When you have completed your application, click once on "Submit My Application." This form will be transmitted in e-mail format. Please ensure your browser's e-mail settings are correct. If you do not see an error message or a blank e-mail window when you press "Submit My Application", your form has been sent successfully. If a blank e-mail message window opens, your browser's e-mail settings are incorrect.

The education officer will confirm receipt of your online application within a few days. Please e-mail us after five business days (education(at)bios.edu) if you have not been notified by the education officer that your application has been received.