Membership Application


For Club Membership, include the following information below and email it to:
GottaDive@ScubaErau.com

  1. Last Name, First Name

  2. ERAU Box Number

  3. Permanent Address, City, State, Zip Code

  4. Cell Phone, Home Phone

  5. Gender

  6. Student Status

  7. Current Certifications

  8. Company Certified By

  9. Date of Birth

  10. Height/Weight

  11. Equipment you Own

  12. Interest: Professional/Recreational/Adventure Diving

  13. Email Address