Wreck n Tek Diving

Call us at: 904-994-6586
Visit us at: 450-160 State Road 13 North #175 Jacksonville FL US
 SCUBA-Training.net


If you have previously enrolled in one of our online courses, please DO NOT create another student record (UserID and Password) here!!! Please click the menu item named 'Login', enter your EXISTING UserID and Password, THEN click the 'Redeem Another Sign-Up Code' button, AFTER you have logged in

The first step in enrolling in a SCUBA-Training.net course is to collect the student information. Please fill out this form carefully as the data contained is used in creating your permanent record


First Name: Last Name:
E-mail:
 UserID:
 Password:
We encourage that your e-mail address also be your UserID, but do not require it.
Your UserID and Password will be E-mailed back to you

Mailing Address:
City:
State/Province/Country:
Zip/Postal Code:
Phone:
 Fax:
 Mobile Phone:

Your name as it will appear on diploma:

Dive training level, agency and certification number (if any):

Year of birth: * required

You are now enrolling in the Nitrox Diver course and your credit card will be charged $ 149.95 .


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