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VOLUNTEER REGISTRATION
VOLUNTEER REGISTRATION

VOLUNTEER REGISTRATION

First Name*

Last Name*

Company

Address*


City*

State*
Postal Code*

Country*
Email*

Day Phone*

Evening Phone

Input Birthdate:  Month Day, Year (ex. April 4, 1994)

Please check the box that applies to you.
In what capacity/capacaties would you like to volunteer your time? Ex. Outreach, Admin, Fundraising, PR, Dive Volunteer.

Please check general volunteer availability

Please check general volunteer availability


Please check the SCUBA Certifications that you currently hold.  Before becoming a dive volunteer, your certification cards will need to be confirmed.
Please indicate Agency of Certification

Please indicate Agency of Certification


Enter certification number of highest SCUBA Certification:

Enter certification number of highest SCUBA Certification:


Verifier

Verifier

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