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Your Contact Information
Name:
Phone:
Email:
Country:
Contact number in Philippines:
Accommodation
Room Type
No. of Rooms
Standard Fan
Arrival Date:
Deluxe (aircon)
Departure Date:
Superior (aircon)
Number of people in your group:
Family (aircon)
adults
children
Dive Information
Are you interested in scuba diving?
Yes
No (if
not
diving with us leave this section blank!)
Do you have your own equipment?
Yes
No
Are you interested in a diving course?
Yes
No
Which course?
open water diver
advanced open water
specialty diver
master scuba diver
rescue diver
dive master
dive instructor
What certificate level are you now?
open water diver
advanced open water
specialty diver
master scuba diver
rescue diver
dive master
dive instructor
How many dives have you done?
How many divers are in your group?
Travel Details
Would you like us to arrange transport?
Yes
No
(if no leave the rest of this section blank)
Pickup from
Airport
Hotel/Residence
Flight arrival date:
Arrival time:
Flight number:
or
Hotel Name:
Hotel/Residence Address:
we will contact you to arrange the pickup time
Other Information
Please note here any information not already captured above