Membership Application

Personal Information

Name: *

Email: *

Phone (+ext): *

Mailing Address:

City:

State:

Country:

Zip Code +4/Mailing Code:

Dive Certification

Highest Level:

Certifying Agency:

Current Memberships

(select all that apply)

AAUS MemberADC MemberAZA Member
Other:

Membership Level Applying For (see below)

ProfessionalAssociateEmeritus

Membership Level Definitions:

Professional Membership: Dive professionals, defined as a paid employee of an institution holding a current, active instructor certification from an internationally recognized agency (or equivalent certification), actively involved in the administration of a diving program consistent with the mission and objectives of The Association are eligible for Professional Membership. Professional Members may vote during all election periods, serve on the Board of Directors, attend all regular meetings and symposia of The Association and have access to online resources provided by The Association.
Associate Membership: Paid employees who are not professional divers, as defined by these bylaws, but are actively involved in the administration of a diving program consistent with the mission and objectives of The Association are eligible for Associate Membership. Associate Members may attend all regular meetings and symposia of The Association and have access to online resources provided by The Association but may not vote or serve on the Board of Directors.
Emeritus: Those members who have retired from professional diving field but remain active within the ADPA.

Referred to ADPA by:

Referrer Name:

Institution Information

Institution:

Mailing Address:

City:

State:

Country:

Zip Code +4/Mailing Code:

Business Phone (+ext):

FAX:

Annual Attendance:

In your institution, you are a

Salaried EmployeeIndependent ContractorVolunteerOther

Immediate Supervisor

Name:

Title:

Email:

Phone (+ext):

Number of Institution Divers

Staff:

Volunteer:

Number of Dives (Annually)

Staff:

Volunteer:

Diving Activities

Staff

ResearchVisitor Paid Dive ProgramsExhibit HusbandryEquipment RepairFeeding ShowsCollectionGuidesSurface Supplied Air System

Volunteer

ResearchVisitor Paid Dive ProgramsExhibit HusbandryEquipment RepairFeeding ShowsCollectionGuidesSurface 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 ADPANO - I DO NOT certify that my program and its goals are consistent with the ADPA