This form is to be used by an individual who is applying for registration for the CTB Certification Program for Recreational Scuba Diving. Please, complete this form after you have read the document ‘Information Booklet - CTB Certification Program Recreational Scuba Diving’. For questions relating to this form, please contact CITI via audit@citi.cw.

To apply for participation in the CTB Certification Program for Recreational Scuba Diving, please fill out all fields below.

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* 1. Business Name:

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* 2. Your name:

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* 3. Your job role in the business:

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* 4. Phone Number

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* 5. Email address:

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* 6. Business address

Declarations

For each statement listed below, please signify your completion and/or acceptance of the requirement by checking the boxes below.

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* 7. I confirm that I have read the document ‘Information Booklet - CTB Certification Program Recreational Scuba Diving’. And I confirm that I agree with the program’s terms and conditions.

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* 8. I declare that the information provided in this registration form is true and correct.

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