Diveplanit Travel: Client Information Submission Form

1. Admin Info

Full name as you want to see on your booking, tickets and invoice*

Prefix First Middle Last

Email address for correspondence regarding this booking*

Phone*

This is the number we’ll call if we need to get hold of you quickly. Mobile is preferred as we can text you too.

Address (for your invoice only; we don’t post anything)*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Preferred payment method*

I will pay via bank transfer without fees
I will pay by card and accept TravelPay's merchant fee
Ask me for each payment

Emergency / Alternate contact

If you would like to give us an alternate contact please enter a full name, followed by phone number

2. Diving details

Current level of certification and certification agency e.g. PADI Advanced Open Water*

Approx. number of dives completed to date*

Nitrox certified?*

Yes
No

Dive Insurance

If you have dive insurance such as a DAN or DiveAssure policy, please enter the policy name, number and validity period.

3. Equipment Hire

ONLY If you regularly hire equipment, please let us know what and the sizes

Please indicate the components you usually require

BCD
Regulators
Dive computer
Wetsuit
Mask, snorkel, Fins
Wet suit

Hire equipment size

Please let us know the equipment size if you know it. E.g., BCD=XL; Fins=44-45. Or your weight, height and shoe size (esp. for wetsuit and fins)

4. Passport details

ONLY If we are booking international flights or a liveaboard do we require your passport details. Please double check these once entered, as changes incur fees once tickets are issued. Alternately, just email us a photo of your details page.

Name as per your passport

If you have one or more middle names, please enter them in the middle name box

First Middle Last

Nationality

Date of Birth (dd/mm/yyyy)

Passport number

Issuing Country

Passport Expiry Date (dd/mm/yyyy)

5. Travel arrangements already in place

ONLY If you already know your travel arrangements, please share them with us. It helps us greatly in the event of unforeseen circumstances. (Or email your itinerary to info@diversiondivetravel.com.au if that's easier)

PRE-TRIP arrival date (dd/mm/yyyy)

Arrival time (HH:MM hrs)

:

Arriving on Flight number

Arrival airport (name or code)

PRE-TRIP staying at name of resort or hotel or "direct from airport"

POST-TRIP staying at name of resort or hotel or "direct to airport"

Departure airport (name or code)

Departing on Flight number

Departure Flight Date (dd/mm/yyyy)

Departure Flight Time (HH:MM hrs)

:

Travel Insurance

If you have travel insurance, please enter the insurance company name, the policy name, number and validity period.

6. Any other relevant information

Additional information

Please any other information that you would like to share, e.g. dietary requirements, assistance requirements, phobias, favourite brand of champagne …

Phone

This field is for validation purposes and should be left unchanged.

Diveplanit Travel: Client information submission