* indicates required field Applicant information
First Name *
Last Name *
Please use an address where you can receive BMSC communications for the foreseeable future
Mailing Address *
Mailing Address line 2
Province/State * --- --CANADA-- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory --UNITEDSTATES-- Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming --AUSTRALIA-- Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia
Postal/Zip Code *
Country * --- Canada United States United Kingdom ----- Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Armenia Aruba Australia Austria Azerbaijan Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire Bosnia and Herzegovina Botswana Bouvet Island (Bouvetoya) Brazil British Indian Ocean Territory (Chagos Archipelago) British Virgin Islands Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Curaçao Cyprus Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kazakhstan Kenya Kiribati Korea Korea Kuwait Kyrgyz Republic Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Netherlands) Slovakia (Slovak Republic) Slovenia Solomon Islands Somalia South Africa South Georgia & S. Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard & Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkey Turkmenistan Turks and Caicos Islands Tuvalu U.S. Virgin Islands U.S. Minor Outlying Islands Uganda Ukraine United Arab Emirates Uruguay Uzbekistan Vanuatu Venezuela Vietnam Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe
Phone Number (Format: XXX-XXX-XXXX)
Diet Restrictions/Special Diet
Bamfield is located in a remote setting, far from hospitals – please indicate if you have any medical conditions we should know about. Please bring you medical card with you.
Payment of the registration fee is required for us to hold your space in the course.
Payment deadlines: Wilderness Guide Workshop: April 26, 2019
Please call 250-728-3301 ext. 226 to pay by credit card, or mail your cheque to:
Bamfield Marine Sciences Centre
100 Pachena Rd.
Bamfield B.C., V0R 1B0
Attn: Field Trips Coordinator, Re: Wilderness Guide Workshop
If the workshop is cancelled, you will be contacted by May 1, 2019 and a complete refund will be issued.
*Notes about room and board: The workshop begins on the afternoon on May 10. Room and board will be covered for May 10 (dinner) through to the final morning of your workshop (breakfast and bag lunch).
Accommodation will be provided in the dormatory in shared rooms. To help us determine room assignments, please provide the following information:
Female Male Other
Name of preferred roommate (if any):
Any additional needs (eg. requiring accommodations before or after the workshop) may be accommodated (depending on housing availability at BMSC).
Additional Information or Questions Section
If desired, please fill out this section so that we may know more about you and tailor the workshop accordingly. All participants are accepted on a first-come-first-serve basis, this information will not affect whether you are accepted, and will remain confidential.