COURSE START DATE: AUGUST 7. 2018

 

COURSE END DATE: OCTOBER 27. 2018

 

NOTE: PLEASE PRINT IN INK

 

 

NAME: Last _______________________________First_____________________________Middle Initial ______________

 

ADDRESS: _________________________________________________________________________________________________

 

PHONE: __________________________________________ ALT PHONE: __________________________________________

 

D.O.B: _________________________________________________ AGE: ___________________ SEX: _____________________

 

EMAIL: _____________________________________________________________________________________________________

 

EMERGENCY CONTACT:_____________________________________________RELATIONSHIP___________________

 

EMERGENCY CONTACTS PHONE: _______________________________________________________________________

 

        Please note that this is an application only. It will be used for the sole purpose of holding your position in the Commercial Diving Program for 2018. Upon arrival you will be given a binding contract to review and sign.

 

        Photocopies of Standard First Aid/CPR, SCUBA Certification, Diving Medical (see web site for medical form and hyperbaric physicians) and proof of Grade 12 or equivalent due prior to

the start date of the program.

 

Fees:

 

        Deposit - $1500.00 (Canadian Dollars)

        Category 1 Commercial Diver 12 week course - $20 500.00 (Canadian Dollars)

 

        Room and Board (Chapleau Lodge) - $4500.00 (Canadian Dollars)

        Books/Materials are available to be purchased through CWDI upon request Approx. $300 List of books required can be found on the CWDI website.

All statements are true to the best of my knowledge. Providing false information may lead to expulsion.

 

SIGNATURE: _______________________________________________________ DATE: _______________________________

 

 

PLEASE MAIL APPLICATIONS INCLUDING DEPOSIT TO: CANADIAN WORKING DIVERS INSTITUTE c/o John Pegg 18529 Kent Bridge Road, Morpeth, ON, N0P 1X0 Canada