Methods in tropical reefs monitoring (7th Reef Check course at Bangka Island)

Bangka, north Sulawesi, Indonesia, 27 October – 04 November 2018

Application form First name (*) ______________________ other name initials ____________ Family name (*) ____________________ Nationality (*) ___________________________ Date of birth (*) ______________________ Place of birth (*) ______________________________________________________ Contacts: E-mail (*) ___________________________ Phone ____________________ Skype ____________________ Education level reached (*):

Bc -

MSc -

PhD - others ______________________________________________

Diving level (*): ____________________________________________________ n. of logged dives (*) _____________ English level (*):

beginner (A) -

intermediate (B) -

proficient (C) -

native speaker

Roommate name, if known: ___________________________________________ or

1

availability to share room (*)

Specify allergies, medical restrictions and/or special dietary needs __________________________________________ Fellowship application It may cover totally or partially the accommodation costs (option available only for undergraduate st students or young (<28 yrs.) graduate biologists). Submission deadline: 31 of May 2018 Attachments mandatory for fellowship application, and otherwise needed upon confirmation (PDF or JPG) nd

Diving certificates (minimum 2 level, allowing down to 30 m in depth) Dive logbook (minimum 30 logged dives) Curriculum Vitae Attachments mandatory upon confirmation (PDF or JPG) Passport (valid at least 6 month after arrival) Medical certificate (written in Italian, English or Bahasa Indonesia) International diving insurance (e.g., DAN, DiveAssure, AquaMed) Non-refundable deposit of € 200.00 (to Reef Check Italia onlus by bank transfer or PayPal) Note: in order to properly organise transport from/to Bangka, every participant must arrive to Manado downtown or airport within 27th October 2018, at 9 o’clock, and leave from Manado airport not before than 4th November 2018, at 15 o’clock. Longer stay in Bangka must be agreed with Coral-Eye well in advance. (*) Submission date: ______________________ Signed virtually through the submission of the form Please, submit this form and any other documents by e-mail to [email protected] (*) This information is mandatory 1 No single rooms available Reef Check Italia – onlus c/o Dipartimento di Scienze della Vita e dell’Ambiente, Università Politecnica delle Marche, Via Brecce Bianche, Monte Dago, 60131, Ancona. Web site: www.reefcheckitalia.it e.mail: [email protected]