Deep Diver Independent Learning Course

Appendix A-1.1
Forms
Personal History Form

Please tell us about your personal history as it relates to diving. In particular tell us about your;
   
  • Year First Certified
  • Current Recreational Level of Certification
  • Total Number of Dives
  • Total Number of Dives in Last 12 Months
  • Your SAC Rate
  • Current Technical Level of Certification
  • Deepest Dive Depth
  • Deepest Dive Depth in Last 12 Months
  • Number of Dives in Doubles

 

In addition, tell us any thing else about your diving history that might help us better understand where you are coming from.

And finally, tell us why you are interested in taking a deep diving course so that we can make sure that we take your special interests into account.

Attach additional pages if you wish.

 

 

 

 

 

Student Information
Name Birth Date Age
Mailing Address Line 1
Mailing Address Line 2
City State Zip
E-mail
Home Phone Business Phone

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