Pelican Divers Dive Evaluation Form
Thank you for your inquiry. This short form is for us to get to know a lil bit more about yourself and the time that you'd be free to do your assessment with us. Sound cool? Fill away!

The dive assessment is RM150 per diver. (inclusive of full gear, tank and weight belt rental)

The location will be held at PJ Palms near Amcorp Mall or at Pusat Akuatik, Shah Alam

*Please know that all your answers and information is held private and is only for our records.
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Name *
Full name please
Date of Birth *
MM
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DD
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YYYY
Handphone number *
eg: 012 345 6789
What method(s) do you prefer to be contacted by ? *
Required
Your best email address *
What is your current level of diving? *
PADI or equivalent
When was your last dive? (sea or pool) *
Just a rough estimate.
MM
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DD
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YYYY
Do you own your own diving equipment? *
Check ones that apply
Required
Do you have a particular date that you have in mind to do this Dive Assessment?
Keep in mind there is a RM15 surplus on weekends
MM
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DD
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YYYY
And on that date what time block would be most suitable for you?
Extras and Special Requests
Anything that you'd like us to keep in mind throughout your course? eg; Whether you're joining solo, with a group of friends or as couple. *We can't promise that we can fulfill all your needs however we will do our best to make it work for all parties
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