Instructor Application Instructor Application Name First Last Email PrerequisitesPlease enter the name of the agency that issued your prerequisite certification. For certifications other than NovoScuba, please select the agency that certified you and upload a copy of your certification card. To avoid delays ensure that your image clearly shows your full name, certification level, certification date and certification agency.Independent Diver/Open Water Diver(Required)NovoScubaPADISSIRAIDSDICMASOtherPlease enter the name of the certification agency that issued your Independent Diver/Open Water Diver certification Dive Explorer/Advanced Open Water Diver(Required)NovoScubaPADISSIRAIDSDICMASOtherPlease enter the name of the certification agency that issued your Dive Explorer/Advanced Open Water Diver certification Rescue Diver(Required)NovoScubaPADISSIRAIDSDICMASOtherPlease enter the name of the certification agency that issued your Rescue Diver certification Divemaster(Required)NovoScubaPADISSIRAIDSDICMASOtherPlease enter the name of the certification agency that issued your Divemaster certification Upload your certification card(s) for courses not certified through NovoScuba Drop files here or Select files Max. file size: 10 MB. Missing PADI Certification Card? Use PADI Diver Verification to access your certification recordsMissing PADI Certification Card? Use PADI Pro Check to access your certification recordsMissing SSI Certification Card? Use SSI Diver Verification to access your certification recordsMissing RAID Certification Card? Use RAID Diver Verification to access your certification recordsMissing SDI Certification Card? Use Missing CMAS Certification Card? Use CMAS Diver Verification to access your certification recordsFirst Aid(Required)NovoScubaEFRSSIRAIDDANOtherPlease enter the name of the certification agency that issued your certification Upload your certification card or certificate for First Aid Drop files here or Select files Max. file size: 10 MB. Diving MedicalDate of Diving Medical DD slash MM slash YYYY Your medical is more than one year old. Your application requires a medical examination within the last 12 months.Please upload your current diving medical. Your medical must be dated within the last 12 months. Drop files here or Select files Max. file size: 524 MB. Consent and SignatureConsent(Required) I hereby declare that all the information I have provided is true and accurate to the best of my knowledge. I have read the Membership Agreement and hereby consent and agree to the terms and conditions in their entirety. I understand and agree that any criminal conviction on my part involving abuse of a minor or sexual abuse of an adult occurring either during or prior to my membership with NovoScuba, will be automatic grounds for denial or termination of my NovoScuba Membership. I hereby certify that all the above statements are true and correct to the best of my knowledge.Signature(Required)Date(Required) DD slash MM slash YYYY