College Application Marine Science And Nautical Training Academy MANTA College Student Application (*Required Field) Student Applicant Information *First Name *Middle Name *Last Name Nickname *Email Address *Date of Birth Country of Citizenship *Male/Female *Telephone *Address *City *State *ZIP Passport Number Passport Expiration Date Parent/Guardian Information *Mother's Name *Home Phone *Address *Email Place of Employment Work Phone *Father's Name *Home Phone *Address *Email Place of Employment Work Phone *Which parent is first point of contact Student Merit/Eligibility Information *College/University Name *Year ---FreshmanSophomoreJuniorSeniorOther *Current GPA *College Major If undecided major, which majors are you considering *List of biology, marine biology, environmental science courses that you will have completed before this trip. *List of Extracurricular activities *Level of SCUBA certification (no experience necessary) *If SCUBA certified, what was the certifying organization (e.g., PADI, NAUI) In 5 sentences or less, describe why you want to enroll in MANTA's program and what do you hope to gain from the experience A recommendation may be required before acceptance into the MANTA program. While the MANTA program is a unique experience, it is physically, socially and academically challenging. Please identify a professor that can provide a recommendation for you, and they may be contacted. Recommending Professor Information *Have you asked your professor if they are willing to give you a recommendation ---yesnonot yet *Professor's Full Name *Professor's Affiliation (e.g., School Name) *How do you know this professor (e.g., Biology professor) *Professor's Email please complete question to discourage spam: + 27 = 37 Δ