Membership Application

[required fields *]

INFO
Name * Name you would like to be called (ex. Robert - Rob)
Email * Title(s):
Immediate Supervisor at your institution
Name: Title:
Email: StateZip:
Dive Certification
Highest Level: Certifying Agency:
Institution INFO
Name: Mailing Address:
City: State:
Country: ZIP +4/Mailing Code:
Business Phone#: Fax#:
Cellular Phone# : Email:
Personal INFO
Mailing Address: State:
City:  
Country: ZIP +4/Mailing Code:
INSTITUTION
#of divers: STAFF VOLUNTEER:
#of dives annually STAFF: VOLUNTEER:
Annual Attendance:    
CURRENT MEMBERSHIPS
[check all that apply]
AAUS Member ADC Member
AZA Member Other:
STAFF Diving Activities of Institution
[check all that apply]
Research Feeding Shows
Visitor Paid Dive Programs Collection
Exhibit Husbandry Guides
VOLUNTEER Diving Activities of Institution
[check all that apply]
Research Feeding Shows
Visitor Paid Dive Programs Collection
Exhibit Husbandry Guides
Equipment Repair Surface supplied air system

I am aware of the mission and objectives of the ADPA, which are:

  • To provide a professional forum for the creative exchange of ideas, information, support and solutions within the community of diving program administrators.
  • To develop a network to facilitate regular and convenient communication between diving programs.
  • To assist and encourage diving programs in maximizing their potential for public education, aquatic conservation efforts and preservation of the environment.
  • To support and assist diving program administrators in meeting the common challenges of maximizing diver safety, effective use of human resources and professional development.

By submitting this application, I certify that my program and its goals are consistent with ADPA, and that one of my interests in becoming a member is the exchange of ideas and knowledge with the other members of the ADPA.

YES - I certify that my program and its goals are consistent with the ADPA
NO  - I DO NOT certify that my program and its goals are consistent with the ADPA