Friday Harbor Laboratories

STUDENT APPLICATION FORM for Spring, Summer, Autumn 2015

First Name (given name)
Middle name or initial
Last name (family name)
Former Name (if not applicable leave blank )
Nickname (how you would be preferred to be called )
Current Mailing Address:
Street & Number
Permanent Mailing Address:
Street & Number
Contact Phone, Area Code and Number
Email address
Alternate Email address
Country of Citizenship
Country of Residence
If you are not a U.S. citizen and have a visa,
what kind is it?
Date of Birth
Gender Male Female
Are you currently a resident of Washington State? Yes No
If "yes" list date Washington residency began
University of Washington Student Number (if applicable):
What will be your ACADEMIC STATUS when you begin the course or apprenticeship at FHL
Current college or university, if matriculated (EXAMPLE: Univ. of Washington) or if not currently matriculated, list the institution last attended including the degree and date (EXAMPLE: Univ. of Washington (BS 6/02)
Field of Study or Degree with Major
In the box to the right, please list all colleges you have previously attended. List most recent first. Include dates and degrees, if any. Please include any courses or research apprenticeships you have previously attended at UW-Friday Harbor Laboratories including term and year. (Please be brief; do not exceed 600 characters, or approximately 75 words.)
Select 2015 Courses and Apprenticeships
Please carefully select course choices in one or all of the terms below; you do not need to apply for all terms. For each term (Spring, Summer A, Summer B, Post-Summer and Autumn) you may apply for one course plus an alternate but may attend only one course per term. Students may attend multiple terms.
Spring Quarter Term
First Choice
Alternate Choice
Summer A Term
First Choice
Alternate Choice
Summer B Term
First Choice
Alternate Choice
Post Summer (workshops)
First Choice (both may be chosen)
Second Choice (both may be chosen)
Autumn Quarter Term
First Choice
Alternate Choice
Are you applying for financial aid?    Yes   No
If so, please download the Financial Aid Request form and e-mail it to
Diving under University auspices or on the premises is limited to scientific work required by a course or for a project which is approved by an instructor/supervisor. All diving must be conducted according to AAUS standards and permission arranged IN ADVANCE with a minimum of 6 weeks' notice. Please contact Pema Kitaeff,, with questions or to start the process.
Do you plan to use SCUBA?     Yes     No
We encourage students to bring their own bedding. Two blankets and a pillow are provided free of charge to each student.

Students may rent or purchase bedding from FHL: 2 flat bed sheets (no fitted sheets are available), one pillowcase and one towel.
Rental Cost = $10 per week, i.e. $50 for 5 weeks, or $100 for a full quarter (10-11 weeks), to be exchanged weekly for clean linens.
Purchase Cost = $30 one-time fee, linens must be self-laundered.
Do you plan to rent bedding?     Yes    No
Do you plan to purchase bedding?     Yes    No
OPTIONAL: Please indicate your race/ethnicity. This information will not affect FHL admission decisions nor financial aid awards from state funds, but it is helpful to FHL when seeking financial aid from non-state sources.
To help us better track our advertising efforts, please specify how you first learned about these FHL course offerings:
By submitting this form, I certify that the above information is complete and accurate. I acknowledge that failure to disclose complete and accurate information may result in denial of admission or dismissal from the University. I acknowledge that physical injury and death are risks inherent in the use of these facilities, and I assume all associated risks and I agree not to claim against the University for those risks. I agree to hold the University of Washington harmless from any and all injuries, damages and liabilities that may occur in the course of my visit, except for negligent acts or omissions of the University or its employees, students or agents acting in the scope of their duties.
The University of Washington reaffirms its policy of equal opportunity in education regardless of race, color, creed, religion, national origin, sex, sexual orientation, age, marital status, disability, or status as a disabled veteran or Vietnam era veteran in accordance with University policy and applicable federal and state statutes and regulations.