Short MoA Sign Up Form

Morse Alpha Expeditions Application
Name

First NameLast Name
Expedition First Choice
Expedition Second Choice
In case your first coice is unavailable
If you will be joining us with a partner or friend, and can share a cozy bunk with them, please put their name here (they also need to fill out their own form)
Your Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Phone Number

Country CodeArea CodePhone Number
Email
please use a unique email address for each participant
Date of birth

MonthDayYear
Date
Gender
Pronouns
Occupation
Check the items that challenge you physically

Hearing someone talk in the same room (w/ or w/o hearing aids)Reading road signs, books, maps at a reasonable distance (w/ or w/o glasses)Go from seated to standing to kneeling with easeClimb a five-step ladderNone
How Did You Hear About Us

Boat ShowSeminar/WebinarPodcastYoutubeGoogle SearchFriend/Former StudentMagazineOther
Please be more specific: which one, from whom, etc.
What Is Your Sailing Experience Level?

Novice: Just startingBasic: Sailed a few times, know the basicsIntermediate: I can sail a boat, and get home (usually!)Advanced: I'm sailing/cruising my own boat
What areas do you need to improve in your sailing/cruising skills? What kind of problems are you having in your quest for sailing independence, freedom and confidence?
We can accommodate the following food allergies and special diets. Do you have any of these needs?

NonePeanutTree NutsLactoseDairyGlutenShellfishVegetarianVegan
Deposit

A non-refundable deposit of $300 is required to secure your bunk. In the unlikely event we decline your entry into the program, the deposit will be refunded. We will send a follow up questionnaire and invoice for 50% after this short application is reviewed. Final payment is due 80 days prior to the expedition start date.
Payment Method

Please Call MeCredit Card Now

Should be Empty:

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Morse Alpha Expeditions Application

Deposit