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Huntsman Marine Academy
Student Application/Medical Form

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Huntsman Marine Academy Student Application/Medical Form

* fields are mandatory

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(Communication between the Huntsman and course participants will be through email) 

EMERGENCY INFORMATION - Confidential

Give the name and contact information of a person who can be reached in an emergency, during the course dates.

MEDICAL INSURANCE

HEALTH INFORMATION

Vegetarian

Please give any drug sensitivities, regular medication and other information that might be of significance to a physician or hospital treating you in an emergency situation.

Each applicant student must prepare an essay describing their career aspirations and why this specific course would help them to meet these objectives. Please upload your essay of up to 350 words maximum here.

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