Tech Course Registration

Which class are you interested in taking?*

Contact Information

Name

First
Last

Business / Agency

Phone

Fax

Mobile Phone

*Please provide a mobile number where you can be reached on the day of the class.

Email

Please indicate which address you would like your certification mailed to: (You will be prompted for the specific addresses when you Checkout) *

Enter name(s) as you would like them to appear on certification card(s)

** Please be sure to list each person taking the class. (On this order) **

Tell us a little bit about yourself…

Do you own/use Full Face Masks?

Which Type(s)?

Do you own/use Underwater Communications?

What brands and type?

Type of diving you do?

Branch

Payment Information

*Note* A $25 restocking fee will be applied for all cancellations – Deadline for pre-registration is 5 business days before class date.

Important Notes

Everyone taking the course must fill out this form. However, if your department is paying for the entire class, only one form has to be filled out with the accounting information. If you are taking the course as an individual, please submit payment with the registration form. If you are paying with a check, money order or bank check, please remit to: Ocean Technology Systems, 3133 W. Harvard Street, Santa Ana, CA 92704 USA – Attention: AGA Course

Technician Course Registration

Contact Information

Tell us a little bit about yourself…

Payment Information

Important Notes