Marine and Environmental Science Program Application Form

Applications are accepted until each session is full. Students should be 16 years of age at the commencement of the program and have completed Grade 10 academic science courses and at least one or more senior level courses ("U" or "M" designated courses in Ontario). Age and grade exceptions may be made at the discretion of the student's Guidance Office and Ocean Educations Program Director. No prior scuba diving experience is required. A refundable $750.00 deposit must be received with the completed application form (parts A, B & C) to process application. Applicants will be notified by mail of acceptance into the program. Since signatures are required from parents/guardians, applicant and the applicant's guidance counsellor, we request that you print this application form and forward it by mail along with 2 wallet sized photos and deposit to: Ocean Educations Ltd., 341 Price Road Salt Spring Island BC Canada V8K 2E9.

Parts A, B & C must be completed. Note: Part C to be completed and returned by Guidance Counsellor

******************************* PART A *******************************

Applicant Information:

First Name:__________________ Initial:____ Last Name:___________________

I like to be called:________ Age:___ Sex:___ Birthdate: MM__/DD__/YY___ Citizenship:______

Applicant Lives With:    Both Parents__,    Mother__,    Father__,    Other_______

For wet suit sizing: Height: _____ Weight: ______ Inseam (crotch to ankle): ______

Are you a certified diver? Yes____ No____ If yes, please provide certification number(s) ___________________ Please bring your log book to the program if certified.

How did you hear about the program? ________________________________________________

School Information:

School Board:___________________ School Name: _____________________

Grade as of Sept '07: ___ School Address:_______________________ City:__________

Prov/State:___________________ Country:______________ PC/Zip:__________

School phone:(_____) _____-_________ School FAX:(_____) _____-_________

Guidance Supervisor:_______________________ Science Teacher:______________________

Medical Information:

Health Insurance: Prov/State:_____________ Health Card/Policy #_____________

Do you have any medical conditions or special dietary requirements (eg: vegetarian, food allergies, insect allergies, other medical conditions)? Yes___ No___

If yes, please describe:_____________________________________________

EXTREMELY IMPORTANT: Are you currently taking any prescription medicine? If yes, please provide details ________________________________________________________________________

Do you have any history of asthma (childhood or otherwise)? Yes___ No___

If yes, please describe:_____________________________________________

Father's Information:

First Name:__________________ Initial:____ Last Name:___________________

Address:_____________________________________ City:__________________

Prov/State:___________________ Country:______________ PC/Zip:__________

Phone:(_____) _____-________ FAX:(_____) _____-_______ Email:___________

Business Name:_________________________________________________

Bus. Phone:(_____) _____-________ (Ext:_____)

Mother's Information:

First Name:__________________ Initial:____ Last Name:___________________

Address:_____________________________________ City:__________________

Prov/State:___________________ Country:______________ PC/Zip:__________

Phone:(_____) _____-________ FAX:(_____) _____-_______ Email:___________

Business Name:_________________________________________________

Bus. Phone:(_____) _____-________ (Ext:_____)

Person to notify in emergency if a parent cannot be reached:

First Name:__________________ Initial:____ Last Name:___________________

Address:_____________________________________ City:__________________

Prov/State:___________________ Country:______________ PC/Zip:__________

Home Phone:(_____) _____-________ Business Phone:(_____) _____-_______

PLEASE COMPLETE:

__ I wish to attend Session 1: July 12 - July 31, 2008

Or

__ I wish to attend Session 2: July 31 - August 19, 2008

Canadian Students: The fee for Summer 2008 programs is $3,986.61 CDN plus 5% GST. Total = $4,185.94 Following receipt of your application and $750 deposit, a second installment of $1,700 is payable April 15th 2008 and final payment of $1,735.94 is due May 15th 2008. Two post dated cheques with deposit are preferred. Applications received after May 15th are payable in full.

US & Foreign Students: Due to the current fluctuations in the US/CDN dollar exchange rate, payment is requested in Canadian funds. The fee for Summer 2008 programs is $4,185.94 CDN. Following receipt of your application and $750 CDN deposit, a second installment of $1,700 CDN is payable April 15th 2008 and final payment of $1,735.94 CDN is due May 15th 2008. Two post dated cheques with deposit are preferred. Funds may be transferred electronically. Applications received after May 15th are payable in full.

Signatures:

I have read the IMPORTANT INFORMATION section found within this web-site and agree to its terms and conditions. I understand that alcohol, cigarettes, marijuana and narcotics are strictly prohibited while attending this program. I understand that failure to comply with these terms and conditions can jeopardize the safety of participants and will result in immediate dismissal from the Marine and Environmental Science Program. I understand that Pearson College is a non-smoking campus.

Applicant :_______________________________ Date:____________

Parent/Guardian:________________________ Rel'n:__________ Date:________

__ 2 wallet sized photos (for identification and certification card) included

__ $750.00 deposit included

******************************* PART B *******************************

For the applicant: Please describe in approximately one page why you would like to participate in the Ocean Educations Ltd. Marine and Environmental Science Program. Be sure to provide details of current activities or interests which may relate to the course. (Continue on an extra page if necessary.)

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Ocean Educations Ltd.
341 Price Road
Salt Spring Island, BC V8K 2E9
Canada

******************************* PART C *******************************

Instructions to the Guidance Counsellor: This section must be completed and returned to:

Mr. Dave Turner
Director, International Education and Training
Centre for Education and Training
190 Robert Speck Parkway
Mississauga, ON L4Z 3K3
(P)905-949-0049, ext.3222
(F)905-949-6004

In addition, please include: *one copy of the student's transcript (up-to-date) *one copy of the most recent report card.

Guidance Counsellor, please complete:

The student is requesting admission to:

_____ Session 1 (July 12 - July 31, 2008) or _____ Session 2 (July 31 - August 19, 2008)

I acknowledge _____________________________'s application for the Marine and Environmental Science Program and recommend her/his participation. I understand that this program follows the curriculum for the approved Ontario Grade 12 Interdisciplinary Studies Course: Marine and Environmental Science, IDC4U.

Name:____________________ Faculty Position(s): ____________________

School Name: _____________________________ Date:_______________

Signature:___________________________________

Bus. Phone: _________________________

Academic Ability: This student performs at the following level:

    (     ) 50-60%        (     ) 60-70%        (     ) 70-80%        (     ) 80%+

Comments :_________________________________________________________________

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Check List for Guidance Counsellor:

1) ___ Part C (above) completed

2) ___ Transcript included

3) ___ Copy of most recent report card included

Thank You!