1. The Exact Names of All Members in My Party (Travel Ids)—Please include Ages of Children:
2a. My Phone #: 2b. My Fax #:
3. My (Our) City of Departure:
4a. My (Our) Home Address: 4b. My (Our) Home City: 4c. My (Our) Home State (or Country): 4d. My (Our) Zip:
5a. My (Our) Departure Date—1st Choice: 5b. My (Our) Departure Date—2nd Choice: 5c. My (Our) Departure Date—3rd Choice:
6a. My (Our) Preferred Accommodations—1st Choice: 6b. My (Our) Preferred Accommodations—2nd Choice: 6c. My (Our) Preferred Accommodations—3rd Choice:
7. How Many Nights Stay:
8a. My (Our) Scuba Certifications with Org. (PADI, NAUI, SSI, etc.): 8b. Respective Dates:
9. How Many Divers: 10. How Many Non–Divers: 11. Some of Us Snorkel (Y/N): 12. Some of Us Wish to Become Certified (Y/N): 13. While I Dive, the Others Enjoy:
14a. I Dived (How Many Dives?) During Last 12 Months: 14b. My Last Dive Was At: 14c. On (Month/Year):
15. I Bring Along the Following Personal Equipment:
16. We Seek the Following Dive Adventures:
17. We Seek the Following Non–Diving Adventures: