Registration Form

Student Name*

First NameLast Name

Company (If Maritime Industry)

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Mobile Number*

Student E-mail*

example@example.com

Birth Date*

MonthDayYear

Did Someone Refer You To Chicago Maritime School?

Name

Choose the courses you want to attend (This is not the payment section)*

Operator of Uninspected Passenger Vessels Only (OUPV/6-Pack)Master less than 100 Gross Tons (Includes OUPV)Assistance Towing EndorsementAuxiliary Sail EndorsementFirst Aid/CPR/AED Course (USCG Approved)OUPV to Master Upgrade Only

OUPV/Master Course Start Date (Other Courses are as listed on the Course Calendar from our website.

THIS IS THE PAYMENT SECTION - ONLY Choose What You're Paying For Today. A deposit is the minimum required. Full payment is required within 14 days of course start date. *

Deposit to hold a seat - Required as Minimum if not paying in full. (Do Not Select This Option if Paying in Full) Non-refundable deposit holds your seat in the class. Balance is due 10 days prior to course start date. If not paying in full for your class, you must pay this to register. If paying for any class IN-FULL, do not pay a deposit. If within 10 days of any class start date full payment is required to register. The $150.00 portion of any full payment is non-refundable.

$150.00

Operator of Uninspected Passenger Vessels (6-Pack)

$975.00

Master Less Than 100 Gross TonsIncludes OUPV Course (Save $75 on combo)

$1,475.00

Assistance Towing Endorsement

$175.00

Auxiliary Sailing Endorsement

$175.00

First Aid/CPR/AED Course (USCG Approved)Required for USCG License. $10 student discount (Reg. $95)

$85.00

USCG/DOT Drug TestRequired for USCG License. $5 student discount (Reg. $70)

$65.00

OUPV to Master Upgrade Course Only

$575.00

Total

$0.00

Credit Card

Additional Comments

Student Registration Form

Credit Card