Please complete this form in full, and we will email you with a paypal invoice, once your details have been verified and confirmed. And your payment is received, your membership pack/card will be on its way to you... Please allow 10 to 21 days... If you do not receive your card in 21 days, from (cleared) payment date, please report this to admin@itdagroup.net Note: The cost for self certification on-line is just $25.00 USD Inclusive.
If you have completed an ITDA Group International / IHMP Medical or Other ITDA Europe or ITDA Asia S.E. Certification Program within the last 30 days, please register your details here.
Family Name*
First Names*
Date of Birth*
Certification Level*
Your Email Address*
Your Certifying Instructor or Dive Leader*
Instructor ITDA Group No/Ref*
Instructor Email address*
Dive Centre / Facility
Please check any other ITDA Group Training and Certification you would be interested in?
Sports Diving Rescue Diving Advanced Diving Technical Diving Specialist Diving Leadership Levels Higher Education (cert,dip,degree) Occupational / Commercial Diving
Are you Interested in ITDA Group Offers?
Training Branded Products Membership
Please attach a Jpeg photo, head and shoulders only, no dark glasses, 300dpi*
Your Email Address (again Please!) this helps prevent spamming.*
Alternative Email address?
Address*
Town/City*
Post Code / Country*
Emergency Contact*
Contact Language preferred (default is English)*
