S/Y Wisdom Participant Application Form

Name(Required)

First Last

Preferred Name/ Nickname

Date Of Birth

Phone

Email(Required)

Phone Type

Cell

Home

Other

Other Description

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Do you have kids or individuals that rely on you?(Required)

Yes

Do you currently have a valid passport?(Required)

Yes

What are your hobbies and interests?(Required)

When thinking about joining I CAN for a voyage, what excites you the most? (Your answer should be about 500 words)(Required)

What do you think would challenge you the most while onboard? (Your answer should be about 500 words)(Required)

What are some current goals you have for life after the voyage? What would you like to accomplish? (Your answer should be about 500 words)(Required)

Why is joining with I CAN important to you? How do you see yourself benefiting from this voyage? (Try to answer in about 500 words)(Required)

Applicants Signature(Required)

Date Signed(Required)

CAPTCHA

Name

This field is for validation purposes and should be left unchanged.

S/Y Wisdom Participant Application