PPCDL Application Form
Please fill up the form for enrolling for the PPCDL course at One Degree 15 Marina Club. You will receive payment instructions within 24 hours of filling up the form. Your enrollment will be confirmed once the payment is validated.
Email address *
If you are a member, please indicate your One Degree 15 Marina Club membership number
Your answer
Select Dates for PPCDL Course *
Participant's full name *
Please indicate your full name as indicated in your NRIC or passport. This name will be printed on your certificate of attendance.
Your answer
Gender *
Passport or NRIC Number *
This identification number will be indicated in your certificate of attendance and will be used for verification during your theory and practical tests.
Your answer
Country of issue of your Passport or NRIC *
Your answer
Nationality *
Your answer
Date of Birth *
Please note that you must be of at least age 16 to be able to attend the course.
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Contact Number *
Your answer
Mailing Address *
Your answer
Occupation
Your answer
Are you red or green colour blind? *
Are you undergoing treatment for any medical condition? *
If you are undergoing treatment for some medical condition, please elaborate
Your answer
I would like to make payment via *
By moving forward, you hereby agree that your personal details are correct and to be printed on the certificate. Please ensure details are same as your verification document (i.e NRIC or Passport). *
Required
Declarations : 1) I declare that I am/my child is physically fit. 2) I declare that I am/my child is able to swim 50 meters with and without life jacket. 3) I declare that by enrolling myself/my child for and participating in Sea Sports Activities Course at One Degree 15 Marina Club, I will not hold One Degree 15 Marina Club, its members, officers, employees, contractors and partners liable for any accident, loss, damage, injury suffered by my child or myself during the duration of this course, whether such accident, loss, damage or injury shall occur ashore or afloat. 4) I hereby confirm that myself/my child is participating in this course solely at his/her/my own risk and indemnify One Degree 15 Marina Club, it’s members, officers, employees, subcontractors and partners in respect of any claim arising out of this course. 5) I understand that registration will only be confirmed by making full payment fee(s) for the above mentioned course. 6) My registration will be forfeited (with or without prior notice), if full payment is not made 2 weeks prior to course commencement. 7) My payment will be forfeited for no-show or if changes to the course dates are requested by me 5 or less working days from the start of the course. 8) My enrollment may be rescheduled if the minimum number of students for the class is not met. *
Required
I am above 21 years of age *
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