Consultation form

When are you going to dive in Bali ?

How many people taking the dive trip with you ?

Over how many day(s) ?

Are you travelling with your family ? Yes   No

If yes, how many family member(s) ?

Children ? (below 10 y.o)

Senior(s)    ? (above 50 y.o)

Are you all certified diver(s) ? Yes   No

If no, how many certified diver(s) ?

Non certified diver(s)

Do/does any non certified diver(s) plan to participate in the diving program ? (min age 10 y.o)
Yes      No

If yes, how many people ?

Do you need any accommodation during your diving trip in Bali ?
Yes      No

If yes, for how many days ?

What is the level of accommodation that you prefer ?
Budget (< US$ 30/night)
Moderate (US$ 30 – US$ 50/night)
Luxurious (US$ 50 – US$ 90/night)
Boutique Resort / 5 Star Accommodation (US$ 90 and up / night)

To fill up the next questions, please refer to the least experience diver in your group

Level of certification (eq: Open Water, Advanced, etc):

How many logged dives to date ?

When was the last dive ?

Any experience of the following (choose that apply) ?
Drift Dive
Night Dive
Deep Dive (below 18 m)
EANx
Salt Water Dive
Warm Water Dives (25 C and above)
Surf Entry
Wreck Dive
Boat Dive
Cavern Dive
Technical Dive
Other, please specify:

To fill up the next questions, please refer to the general interest of your group

Which kind of underwater attraction you'd like to see? Or What kind of things you'd like to do? (choose all that apply)

Macro (eq: small unusual underwater creature)
Big animal (eq: shark, school of Jacks, Stingray, etc)
Drift Dive
Wreck dive
Muck diver
Deep diver
U/W Photo
U/W Video
Wall Dive
EANx Dive
Other, please specify:

Do you like to do other activity (ies) other than diving ? (eq: rafting, cycling, land tour, etc
Yes      No

If yes, please specify:

If you have any special request or if you need to let us know any information(s) that is(are) not covered in the above questions, please fill up the special request section below: