Registration Form

Student Registration Form

Fill out the form carefully for registration
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. *

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
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Student Registration Form

Credit Card