Registration form, for advertisement on the Longitude181 Guide

Email *

Name of your diving center *

Manager name *

First

Last

Full title *

Address *

Zip code *

City *

Country *

Main phone (with country code)

Mobile phone number

Website

Name and phone of a France based Contact (if any)

Scuba dive training organizations you belong to :

FFESSM PADI FSGT CMAS CEDIP ANMP Other (please specify below)

Specify other Scuba dive training organizations you belong to

Name of any environmental organization you support

thank you for developing the acronyms

Interacting with LONGITUDE 181

Contact name *

First

Last

Title/function

Mobile phone

Email

Preferred language *

Additional details / contact (s)

• SUBSCRIPTION TO LONGITUDE 181 GUIDE - WHO ARE YOU?

The following information will help us knowing more about you, and will show on your page of the Longitude181 guide, once translated into French. This page will provide for the image of the club, together with an assessment of your actions for the preservation of the environment, expressed in a number of planets. By completing this document you agree and commit to display the International Charter for Responsible Diver on your website, in your Dive Center and / or on your boat. You also commit to respect this philosophy while diving. You can download the charters from www.longitude181.org. For Longitude 181 association members (= ambassadors), further supports are available such as posters (self-adhesive or not), or even small plasticized formats for divers.

Your GEOGRAPHICAL AREA *

Are you a community center (i.e. non-commercial organization) ? *

Yes No

Are you a small organization hosting less than 15 divers per trip? *

Yes No

Please give us a short introduction to the dive center *

(i.e. what would you like to highlight on the center, dive sites, your specificities, spirit, dive supervision, etc. This paragraph should make the diver be attracted for a dive with your center, and will be translated into French) - 12/15 lines max

Main environmental activities *

(please describe 2 or 3 environmental activities (conservation, preservation, impact reduction/ mitigation..) currently carried out by the center and you would like to promote)

Diving Center Projects *

(what are you working on to strengthen the preservation of the environment in the coming year(s))

PICTURES

Pictures and logo will display on your page of the Guide. Please note that images should be in JPG or PNG format. The size of the file is limited to 2024KB and you shall have user/copy rights.

Your logo *

Please join your logo

Horizontal picture (minimum length: 350 px) *

Please select a horizontal picture

To illustrate your guide page

Second Picture (minimum width : 350 px) *

Please select a vertical picture

additional picture to be inserted in your page

CERTIFICATE ON HONOR / PICTURES RIGHTS

I, the undersigned *

First name Name

Organization manager *

Title, Name of the center

Statement *

certify on honor by this document, that all pictures communicated to Longitude 181 within the context of the registration in the International Guide of Eco-Responsible Dive Centers, are free of all property and copyrights and that I have the authors agreement to broadcast them.

First assessment guide