Coastal Academy Application Form
Please answer every question in order to help us process your application. Once we receive the form, we will respond within ten working days as to whether you have been successful in securing a place on your chosen course.

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First Name *
Surname *
Preferred Name
Gender *
Date of Birth (dd/mm/yyyy) *
English language ability *
French language ability *
Swimming ability *
Snorkelling ability
Clear selection
Home address *
Contact telephone number *
E-mail address *
Education and qualification history (including current education if still a student) *
Employment history/relevant experience *
Statement of motivation *
Please describe in no more than 250 words your reason for applying for this course and how you believe it will help you in the future
Course(s) applied for *
Required
If successful in your application, do you want the Coastal Academy to include your e-mail address in a list of contact details circulated to course participants prior to the start date in order to facilitate organisation of acccommodation etc.? *
How did you hear about the Coastal Academy? *
Required
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