Make your own free website on Tripod.com

Online Catalog Request Form

This is an explanation of the purpose of the form ...

Please identify and describe yourself:

First name
Last name
Date of birth

Are you a certifed diver ?

Yes No

What is your certification level ?


How many logged dives you have ?


Do you want to be included in the mailing list ?

Yes No

Select the programs you are interested

IDC          	Silver		                 Gold                   Platinum             
IAHD		DAN Oxygen Instructor  Business of Diving     IDC Staff Instructor