PAYMENT METHOD See current price list for payment information.
PADI Standard Card (no additional fee)
Maestro/Solo (UK only)
To help preserve the aquatic environment, please select and indicate the amount of donation:
Check/Bank Draft Number* ______________________________
*Check/Bank Draft must be payable in the currency of the PADI Office the application is submitted to.
Card Number __________ __________ __________ __________ Cardexpirationdate__________Securitycode_________________ Maestro/Solo valid from date ______ Or Issue No. _____(UK only) Cardholder Name ______________________________________
Project AWARE Foundation Card (Contact your PADI Office for minimum donation)
Additional Project AWARE Foundation donation (A donation of any amount is appreciated)
PLEASE DO NOT WRITE IN THIS SPACE
Application completed in full
Prerequisite information completed and required documentation attached
MAIL TO: Your PADI Office Attn. Divemaster Certification For mailing information, see current price list or visit padi.com.
Tape / Attach a 4.5cm x 5.7 cm 1 3 ⁄ 4 " x 2 1 ⁄ 4 " ( a p p r o x . )
Applicant and instructor signatures One photo attached (print name on back)
Please check box if DSD Internship Completion form is attached #10151
Head and Shoulder Photo
PRINT NAME ON BACK OF PHOTO
See price list for fee (Fee includes a quarterly subscription to The Undersea Journal valued at $12 or equivalent in local currency.)
Coin Machine Photos OK No Dark Glasses
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