Membership Form Please enable JavaScript in your browser to complete this form.Thank you for using the form to apply or renew your membership with AVSC. Please complete this form and submit your membership fee via Zelle to avscscubapayments@gmail.com. Name *FirstLastEmail *Phone *AddressEmergency Contact *Emergency Contact Phone *Are you a member of NABS?YesNoNABS ID numberCertification Level *Non-DiverOpen WaterAdvanced Open WaterRescue DiverMaster Scuba DiverDive MasterInstructorCertifying Agency *PADINAUISSIOtherType of Diver *RecreationalTechnicalPublic SafetyNumber of Dives LoggedZero1-5051-99100+Dive Insurance Carrier *How did you hear about us? *Friend or AssociateFacebookTwitterGoogle+MeetupOtherSignature * Clear Signature PayPal Commerce *PayPal CheckoutCredit CardCard NumberExpiration DateSecurity CodeCard Holder NameType of Membership *Initial Individual 1 year - $50.00Initial Individual 2 years - $80.00Renew Individual 1 year - $40.00Renew Individual 2 years - $60.00Initial Family Membership 1 year - $70.00Initial Family Membership 2 years - $120.00Renew Family Membership 1 year - $60.00Renew Family Membership 2 years - $100.00Submit
