HIMB Marine Science Club Application 2018-2019
Please know that this application will probably take at least 10 minutes to complete (unless you are Berry Allen), and there is a 300 word essay included in this application. Please read through the all the questions before starting. You may also write your essay in MS Word so that you can save along the way; then copy/paste here when ready.
Student First Name
Student Last Name
Date of Birth
Please include hyphens (eg: 808-123-4567)
AT&T, Verizon, Sprint, T-Moble, etc...
City / Town
Emergency Contact Name
The first and last name of who we should contact in case of emergency
Relation of Emergency Contact
Ex: My emergency contact is my ________ (Mother, Father, friend, etc.)
Emergency Contact Phone Number
Emergency Contact Email
School Attending for 2018-2019 Academic Year
Grade Level for 2018-2019 Academic Year
What is your heritage/ancestry?
Why do you want to join the Kulia Marine Science Club?
Please tell us who you are, what you're interested in, and what you hope to gain from KMSC?
Method of transportation
How will you be arriving? Select all that apply
Being dropped off by driver
Where will you arrive at the beginning of each program?
HIMB parking lot
From where will you be picked up or leave from?
HIMB Parking Lot
Will you be able to attend all or most meetings?
Only during Fall Semester
Only During Spring Semester
Will you have any other responsibilities that may overlap with the 2:30-5:00pm schedule
Extracurricular activities, work, etc...
How would you rate your swimming ability?
Don't like to swim
Comfortable for short distances (1 pool lenght)
Can swim over 100 yards (4 pool lengths)
Can swim over 500 yards (20 pool lengths)
Able to free dive to 20+ feet
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