Course Booking Form for courses 1 Your Details2 Course Details3 Arrival & Departure Dates4 Medical Form Please take a moment to fill out all fields in this form so we can better handle your questions. Fields marked with * are required. Your Name*Your Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Your Email Address* What courses are you interested in and what is your current certification level?Which course are you are interested in Discover Scuba Diving PADI Scuba Diver PADI Open Water Specialty Course PADI Advanced Open Water PADI Rescue Diver PADI Divemaster Emergency First Response PADI IDC Which specialty courses? Project AWARE AWARE - Fish ID Boat Diver Deep Diver Digital Underwater Photography DPV Diver Emergency Oxygen Provider Enriched Air nitrox Equipment Specialist Multilevel Diver Night Diver Peak Performance Buoyancy Search And Recovery Diver Underwater Naturalist Underwater Navigator Underwater Photographer Underwater Videographer Wreck Diver What is your current certification level?Check the highest qualification you currently have.Not certifiedPADI Scuba DiverPADI Open WaterPADI Adventure DiverPADI Advanced Open WaterPADI Rescue DiverPADI Master Scuba DiverPADI DivemasterOtherHow many logged dives do you have?Please specifyInclude training agency and diver number (if applicable).What is your PADI Member Number What is your arrival date to Sharm? What is your departure date from Sharm? Departure TimeThe time your flight is scheduled to leave Sharm. This is a safety concern regarding current flying while diving guidelines. HH : MM Do you require an airport pick up?YesNoWhat is your arrival time? HH : MM What is your flight number? Please take a moment to fill out and sign this PADI Medical Questionnaire then upload it using the option below. Right click and "Save As".Click here to download Medical QuestionnairePADI Medical Questionnaire (required for ALL PADI courses, including Discover Scuba Diving Program). Upload you completed Medical Questionnaire*Terms and Conditions Please read the terms and conditions Click here to view our Terms and ConditionsI accept Anthias Divers Terms & ConditionsYesNoNameThis field is for validation purposes and should be left unchanged.
