Occupational Diver Registration 

Please complete all the information below to enable us to ensure we match your current details correctly.  If you have any additional information that will help please enter this in the notes section.
Personal Details * denotes a required field
First Name*
Middle Name   
Last Name*  
Date of birth (format dd/mm/yyyy)*  Examples: 02/01/1976, 12/04/1982
Sex* MaleFemale 
Contact details
Email*  
Street*
Suburb
City*
Post Code   
Home Phone
Mobile Phone
Notes   
Please select your username and password 
(please make sure you write this down or keep a copy so you are able to sign on with this once your registration has been approved)
 Username*
   (your username must be a minimum of 6 characters) 
 Password*
 (your password must be a mimimum of 7 characters and must include at least 2 numeric characters)