Apply

World Voyage 5 Application

Personal Information
Sex:
Date of Birth:
Have you ever been convicted of a criminal offence?
Referral Info
(Please be as specific as possible. Some examples might be "Google Search", "ASTA Website", "Email From a Friend" and etc.)
Interest and Contribution
Education and Work/Life Experience
Health and Fitness
Are you claustrophobic?
How are you with heights?
Any allergies (medicines, foods, insect bites, etc.)?
Any major hospitalizations?
Water and Boating Experience
Select which describes dow well do you swim?





Additional Comments
Voyage Leg Selection
Please select legs you are applying for (legs and durations subject to change):
Whole World Voyage 5May 2010 to June 2011
Leg 1May 2010 to August 2010
Leg 2August 2010 to November 2010
Leg 3November 2010 to March 2011
Leg 4March 2011 to June 2011
Please Provide Three (3) Character References
NameRelationshipTelephone Number