Sea, Sun & Science Trailblazers: A Marine Science Experience                              (10th-21st July 2023) Cost:$300
APPLICATION FORM (Form 1-3)
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Email *
Last Name *
First Name *
Date of Birth *
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/
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Age *
Gender *
Required
Permanent Address *
Mailing Address (if different from mailing address) *
Contact Number *
School/ Affiliation *
Form/ Highest Level attained *
Subjects with Environmental content (completed/ currently doing) *
Career interest *
Can you swim? *
Statement of interest: In approximately 250 words, indicate your interest in this programme and how it relates to your overall (career, life, etc) goals. *
PAYMENT INFORMATION
Payments for the Trailblazers (Form 1-3) programme can be made as a direct deposit or online transfer to the First Citizens Bank using the following information and a copy of the receipt sent via email to buccooreeftrust@gmail.com:
                
                 Account number: 1231999
                 Account holder: The Buccoo Reef Trust

Please state in the email the name of the programme that payments are made for and the name of the participants and parent making the payment.

Please note that payment plans are available. A deposit of 50% of the cost of the programme must be made in order to register participants and the full deposit must be made by 21st July 2023 ($300 total cost)
A copy of your responses will be emailed to the address you provided.
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