Booking Form

To guarantee your booking a non-refundable deposit of 1000 Pounds Sterling is required.

1. General Information
2. First Name*
3. Last Name*
4. Mail Address*
5. Email*
6. Phuket Arrival Date -- 01 02 03 04 05 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 ------- January February March April May June July August September October November December ---- 2010 2011
7. Flight Number
8. Phuket Arrival Time ---- 1 2 3 4 5 7 8 9 10 11 12 ---- 00 01 02 03 04 05 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 am pm
9. How many dives have you made? None 4-10 10-20 20-40 50-100 100-200 200+
10. When was your last dive? ------- January February March April May June July August September October November December ---- before 1997 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
11. Certification level None Scuba Diver or Equivilant Open Water or Equivilant Advanced Open Water or Equivilant Rescue Diver or Equivilant
12. Start Date 01 02 03 04 05 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December 2010 2011
13. Number of People -- 01 02 03 04 05 07 08 09 10
14. How Did You Hear About Us? Former Customer Internet Search Engine Magazine Ad Magazine Article PADI Website SSI Website A Friend
15. Enquiries
16.