Ocean Mammal Institute Registration Information for OMI Research Internship 2013 December 31, 2012 - January 18, 2013

•   The number of students in the Research Internship Program is limited.
•   Your application will be reviewed as soon as the registration form and your $100 deposit are received.
•   If selected, your space will be considered filled only when full payment of $2500 ($2400 + $100 deposit) is received.
•   Once all the spaces are filled we will no longer accept applications.
•   In the past, we have received more applications than there were spaces available.
•   The sooner you complete the application process, the better your chance of being selected.

1. Complete this registration form via the Internet. (Once you press the submit button at the bottom of the form your answers to the “Selective Questions” cannot be changed.) NOTE: Please make only one application with all requested information filled in.
   (If you prefer not to register online, please contact joneal@pa.net)
2. Pay a deposit of $100.00 using PayPal or with a check made out to “OMI”.     Click here for Internship Payments
3. OMI will review the application after the deposit and the registration form are both received.
4. If you are NOT selected to attend the Internship your deposit will be refunded in total.
5. If you are selected to attend the Internship your space will be considered filled only after full payment is received by OMI.
6. You can pay the total due by PayPal or with a check to OMI.
   (NOTE: Only VERIFIED PayPal Accounts can send more than $2000 (total) per month.)
7. Remember: You are responsible for your own airfare and food costs.
8. Cancellation Policy:
   If cancellation is received in writing on or before 20 September 2012, your total payment, less an administrative fee of $50.00, will be refunded.
   If cancellation is received after 20 September 2012, only $1500.00 of the total $2500.00 will be refunded due to non-reimbursed hotel expenses.
   If OMI has to cancel the trip, the total $2500.00 will be refunded. Airfare (or other incurred losses) will not be reimbursed by OMI.

Registration Form for OMI Research Internship 2013

YES! I would like to register for:   Field Research on the Hawaiian Humpback Whale

Arrive December 31, 2012.    Depart January 18, 2013.

Here is My Info:     ( If a field is Not Applicable, please type: NA )

Full Name:
	First	Last
Home Address:
	Street
	City		State       Zip
Home Phone:	()		Cell Phone:	()
	(Area)    Phone Number			(Area)    Phone Number
Home E-Mail:
Your School Name:
Your School Address:  For Contacting You
	Street
	City		State       Zip
Your School Phone:	()
	(Area)    Phone Number
Your School E-Mail:
For Credit:	Will you be applying for college credit through your school? No    Yes   If Yes, Fill in Faculty Advisor info below
		Faculty Advisor:   Faculty Advisor Phone:  ( )    Faculty Advisor E-Mail:
Age:	Age on 12/31/2012         Gender:   Male    Female
Comments or Questions:
My Pledge to OMI:	I understand that research is the priority during this internship and that I will be asked to leave if my behavior interferes with this reseach. My Initials:     Date:   ( MM/DD/YYYY )
If Under Age 18:	Name of Parent/Guardian: Note: If you are accepted, we will need their written permission for your participation.

Selective Questions:

Regarding My Deposit

I plan to send my $100 deposit to OMI via:    Paypal    Check