UP 2017 Fall Program Application Form

Apply for Fall 2017

Student Application Procedure

Questions may be directed to University Programs
Email:university@bamfieldmsc.com Phone: 250-728-3301 Ext 216

The Director of BMSC has final authority in accepting students for courses.

On-line Application Form

  • Fall Application Deadline: March 31, 2017
  • Student applications received past the application deadline will be assessed on a first-come, first-served basis

Attachments

Statement of Interest
Transcripts
(Optional) Additional Transcript File 1
(Optional) Additional Transcript File 2
Letter of accommodation (for students with learning disabilites)
Doctor's note for students with food allergies/diet restictions

Applicant information

Prefix
First name
Last name
Nickname
Date of birth (Format YYYY-MM-DD)

Permanent Address

Please use an address where you can receive BMSC communications for the foreseeable future

Street Address
Street Address line 2
Street Address line 3
City
Province/State
Postal/Zip Code
Country

Contact info

Phone Number (Format: XXX-XXX-XXXX)
Email *Must be able to receive attachments
Alternate Email

Emergency Contact

Name
Phone Number (Format: XXX-XXX-XXXX)

Further information

Member university you attend Non-member university students select University of Victoria
Non-member university you attend
Student ID number
Academic standing as of May 1st, 2017 (If you have completed your second year, you are considered a third year graduate)
Field of study, including major
Have you been to BMSC before? Please select all that apply

No, I have not been to BMSC before
Yes, Elementary or High School field trip
Yes, University field trip
Yes, Other educational or group field trip
Yes, Previous BMSC summer or fall university course(s)
Yes, Research/Research assistant

If past trip selected above, please select year
Please name the school you came with, and/or courses attended at BMSC
How did you learn about BMSC?

BMSC Website
Instructor at home university
Academic advisor at home university
BMSC Ambassador at home university
Poster at home university
Digital display at home university
Former/current BMSC student
Social Media (Facebook share or post by friend)

Other (please specify below)

Reference Information

Name of professor who will recommend you
University
Phone
Email

Recommended or Required Courses

If you are currently taking a prerequisite course, select 'TBD'.

Summer or Fall Course Name
Ecology (REQUIRED)
Statistics (REQUIRED)
Invertebrate Biology
Non-Vascular Plants

Boat Use

University Program students are given the opportunity to operate a 14ft outboard boat as part of their courses at BMSC.
All boat operators must have the following before coming to BMSC:

  1. Pleasure Craft Operator's Card (PCOC); and
  2. Marine Basic 1st Aid, Occupational First Aid Level 1, or equivalent (see here)

Boating experience is recommended but not necessary; training is provided on the first day of class. Students will be given the opportunity to practice their skills prior to being given permission to take the boats outside the inlet.

  1. Do you wish to operate boats? If not, please skip next 2 sections YesNo
  2. I would like to operate boats and presently have the necessary certifications YesNo
  3. I will obtain a PCOC and the necessary First Aid certification prior to arriving at BMSC YesNo
PCOC number
First Aid certification
First Aid expiry date

SCUBA

If you intend to dive at BMSC, please consult the BMSC website on qualifying as a Scientific Diver at BMSC. The following list of equipment is REQUIRED. If you cannot fulfill this list, please explain your situation in the text box below.

  1. Mask, snorkel, fins
  2. Dry suit (MANDATORY)
  3. Hood, boots, gloves
  4. Weight system
  5. Buoyancy compensator with low pressure inflator
  6. Regulator
  7. Alternate air source
  8. Submersible pressure gauge
  9. Underwater compass
  10. Bottom timer (i.e. dive watch)
  11. Primary dive light
  12. Back-up dive light
  13. Dive knife
  14. TWO emergency signal devices - one audible, one visual
  15. Small gear bag (i.e. mesh goody bag)
  16. Logbook (minimum 12 dives in 12 months prior to arrival)
  17. NOTE: BMSC will supply you with SCUBA tanks
Do you plan to use SCUBA? YesNo
Will you be able to bring all of the equipment listed? YesNo

Scuba Equipment special notes

Please explain your circumstances if you were unable to answer 'Yes' above

Accomodation

Note: Students will be housed in a co-ed dormitory in shared, same-gender rooms.

Gender (for housing assignment)
Pertinent Medical Issues (confidential; disclosed only to on-site First Aid Officers and instructional staff):
Housing comments (ie name of preferred roomate):

Dietary preferences

Meals always include a meat option and a vegetarian option. To help us determine how much food to order and prepare, please indicate your preferences below. If you indicate that you eat chicken, you will be expected to take the meat option when chicken is served.

I include meat in my diet (please select from the following list)

Beef? YesNo
Pork? YesNo
Chicken? YesNo
Fish? YesNo

I am vegetarian (please select options from the following list)

Milk? YesNo
Eggs? YesNo

BMSC is equipped to accommodate vegetarian/vegan diets. Due to the high number of dietary restrictions received from students in recent years, specific dietary restrictions should be accompanied by a note from a doctor.

List all dietary sensitivities or allergies:

To finish your application please confirm that you are not a robot trying to secretly attend BMSC