Australian Diving Instruction

Dive Club - Membership Form

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MEMBERSHIP APPLICATION

To join our dive club, simply fill out the form below, choose a membership and payment option and press the Submit button below. We will contact you to confirm your payment and membership.

fill in the form below or download a copy here to print.

Application Form

    fields marked * must be completed

Single   $95

Family   $125

Personal Details

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Diving History
 * (NAUI, PADI, SSI, IANTD, Other)
 * (Scuba Diver, Advanced, Master Diver, Dive Master, Instructor, Other)
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Emergency Contacts *
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Membership Details Single $50    $70 *
Preferred methood of newsletter *
I certify that all statements given in this application form are true. *

 

Australian Diving Instruction
31 Melbourne Road
North Geelong
Victoria 3215
Phone: (03) 5272 2181
Fax: (03) 5272 1274
Mobile: 0408 365 216
Email: info@ausdivinginstruction.com.au
www.ausdivinginstruction.com.au

Your Safety Is Our Priority