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Thank you for your interest in our upcoming Programs! Please take a few minutes to complete this application to begin the process. Once we receive your application, we will notify you shortly whether or not you have been accepted and you will then be directed to pay your Deposit to secure your spot on the program. We look forward to having you join the adventure!

Select a Program
Select a Program*
- India 2025
- Patagonia 2025
Please list any fallback options

General Information
Full name*
First
Email Address*
Enter Email Confirm Email
Phone Number*
Birthdate*
Gender*
- Male
- Female
Address
Address*
Street Address Address Line 2 City State ZIP Code

Passport Information
Do you have a valid Passport?*
- Yes
- No
Full Name*
Issuing Country*
Expiration Date*

Academic Info
School you are attending*
What is your major? (Collegiate applicants only)*
What is your GPA?*
Grade Level*

Extra Information
What is your surfing ability?*
Surfboard rental preference*
What is your t-shirt size?*
Is there a friend you'd like to room with?
How did you hear about Sea State?*

Emergency Contact
Name*
Relationship*
Phone*
Email*

A little more about you
Please explain why you chose this program and what you hope to gain out of your participation in your chosen program.*
Have you ever traveled outside of your home country before? If so, what was your favorite travel experience and why?*
At SeaState our groups interact very closely, what personality traits and skills would you bring to enhance the group dynamic on your program?*

Health and Medical Information
Sea State offers programs in many parts of the world, including remote areas. Our programs involve physically demanding activities and full cultural immersion in areas of the world where certain amenities, facilities and treatments may not be readily available. We ask that you carefully consider your general physical and mental health prior to applying and that you answer completely and accurately all questions in this section of the application.
Do you have any allergies to medication, plants, foot, animals, insect stings, etc.?*
- Yes
- No
Question 1 detail
Do you have any physical limitations or disabilities?*
- Yes
- No
Question 2 Detail
Have you ever had any major illness or major surgeries?*
- Yes
- No
Question 3 Detail
Have you ever been hospitalized?*
- Yes
- No
Question 4 Detail
Have you ever been treated by a psychiatrist for psychologist for any mental, emotional or nervous disorder?*
- Yes
- No
Question 5 Detail
Do you have any health conditions affecting your physical health?*
- Yes
- No
Question 6 Detail
Do you currently take prescriptions on a regular basis?*
- Yes
- No
Question 7 Detail
Do you have any dietary restrictions?*
- Yes
- No
Question 8 Detail
Are you a confident swimmer?*
- Yes
- No
Are there any concerns you would like to discuss with Sea State?*
- Yes
- No
Question 10 Detail
Risk release*
- I have read and agree to the Assumption of Risk and Release of Liability
- I have read and agree to the Statement of Financial Responsibility
Comments
This field is for validation purposes and should be left unchanged.

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