Apply Online PERSONAL INFORMATION Name * First Last Father's name Date of birth * Gender Male Female Other Nationality * Studies Email Address * Telephone number * Address * ZIP Code * City * Country * CONTACT PERSON IN CASE OF EMERGENCY Surname/Name * Telephone number * Email address * Languages spoken Native language * Other German French English Greek Italian Spanish Dutch Other : Car Driving licence (EU) * Yes No ABOUT DIVING Have you got a diving certification * Yes No If yes, which one ? — Select — PADI OpenWater PADI Advanced OpenWater PADI Rescue Diver PADI Dive Master PADI Instructor CMAS 1 Star CMAS 2 Star CMAS 3 Star CMAS 4 Star None of the above If you answered "none of the above" to the previous question, please write below your dive certification How many dives do you have ? Date of last logged dive Do you have your own dive equipment ? Yes No If yes, what are you going to take with you ? Mask Fins Snorkel Wetsuit BCD (Buoancy control device) Regulator KOSAMARE VOLUNTEER PROGRAM Do you have a previous experience in a volunteer program ? * Yes No If yes, which one? If yes, for how long ? Choosen Program — Select — Open Water + Volunteer program (14days) - 1230 € Advanced OpenWater + Volunteer Program (14 days) - 1150 € Volunteer Program only (14 days) - 880 € OW + Advanced OW +Volunteer program (17 days) - 1450 € Scientific diving course Choosen period of time if you chose the 2 weeks volunteer program Sunday 2nd May to Saturday 15th May Sunday 16th May to Saturday 29th May Sunday 30th May to Saturday 12th June Sunday 13th June to Saturday 26th June Sunday 5th Sept to Saturday 18th Sept Sunday 18th Sept to Saturday 9th Oct Please select just one period of time. Choosen period of time if you chose the Scientific diving course Sunday 27th June to Saturday 3rd July Sunday 19th Sept to Saturday 25th Sept Sunday 10th Oct to Saturday 16th Oct If you chose both of the programs, please answer the two questions above. You will have to pay 20% of the price to confirm your inscription. The rest will be paid 1 month before the week you subscribe for. * Accept The number of places per session is limited. The 20% will confirm your inscription and save you a place during your choosen session.
