Application Form

Passenger1
First Name
Last Name
Date of birth (yyyy/mm/dd)
e-Mail address
Phone number (**********)
Nationality
Nunber of gust
Where should we pick you up ?
We can pick you up hotel in
Osaka-city,Toyonaka-city and Ikeda-city only.
Tour date (yyyy/mm/dd)
Height (cm)
Weight (kg)
Shoe size 
What is your highest dive certification?
Have you ever dive with drysuit?
How long ago was your last dive?
How many dives have you done?
Gender
Passenger2
First Name
Last Name
Date of birth (yyyy/mm/dd)
Height (cm)
Weight (kg)
Shoe size 
What is your highest dive certification?
 Have you ever dive with drysuit?
How long ago was your last dive?
How many dives have you done?
Gender
Passenger3
First Name
Last Name
Date of birth (yyyy/mm/dd)
Height (cm)
Weight (kg)
Shoe size
What is your highest dive certification?
Have you ever dive with drysuit?
How long ago was your last dive?
How many dives have you done?
Gender
Passenger4
First Name
Last Name
Date of birth (yyyy/mm/dd)
Height (cm)
Weight (kg)
Shoe size
What is your highest dive certification?
Have you ever dive with drysuit?
How long ago was your last dive?
How many dives have you done?
Gender