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NCUPS Registration Form
This is STEP 1 of renewing or becoming a member of
NCUPS. After submitting your information, you will be able to pay for
your membership using PayPal or given instructions on how to mail in your
membership dues. |
Reason for submitting form (click one)
New application
Renewal
If renewing, are you updating your basic information (address, phone, etc.) |
Where did you hear about NCUPS? (check one)
NCUPS Website
Newsletter
Dive Store:
Other:
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Basic Information (Everyone fill in these fields)
* = required |
| * Name |
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| * Address |
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| * City, ST Zip |
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| * Phone number |
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| * E-mail |
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| Website Address: |
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Optional Additional Information (For new members or updating) |
Employer |
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| Position |
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| Type of work you do |
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| Business phone |
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| FAX Number |
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| Name of spouse or partner: |
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Diving Information (For new members or updating) |
| Certification agency and number |
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| Emergency contact person |
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| Emergency contact phone number |
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| Diving experience (year certified and how many times per year do you
dive? |
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| Types of diving that you do
(cold water, warm water, free diving, etc.)
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| Where in the world have you dived? |
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Underwater photography experience (For new members or
updating) |
| How long have you been an underwater photographer? |
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| What type of equipment do you own? |
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| Areas of photographic interest (black & white, video, digital editing,
macro, wide angle) |
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| Areas you might be interested in contributing to NCUPS (pre-meeting discussions
groups, newsletters, board) |
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| What special talents might you bring to NCUPS (don't be bashful)? |
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| Are there any specials programs or seminars you would like to see? |
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