Application for Membership
Name:_______________________________________________ Occupation:________________________
Spouse’s Name (if married):_____________________________ Number of Children:___________
Home Street Address:________________________________________ City_______________________
State__________ Zip_______________ Home Phone:_______________________________
Cell phone:_______________________________ Business phone:___________________________
Business Address: __________________________ City _______________ State_______ Zip________
Email Address:_________________________________

Diving  experience/Certification ____________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________
Rules for Membership
I shall abide by the clubs rules and By-Laws and uphold the constitution to the best of my ability.
I will be considerate of the rights of other members and guests.
I will be considerate of the clubs property and protect it from harm.

Applicant’s Signature:_____________________________________________ Date:__________________
Please submit to: info@inlanddivers.com
IDA Use only
Date application submitted:________________ Date voted on associate membership:_____________
Date for vote on regular membership (1 year):____________ Approved? Yes_____No

Please print and bring with you to the next meeting.