Albanian Diving Federation

*User Type

Position / Title

Example: Technical Director, Manager, ect...

*Username

*Password

Leave blank and password will be generated automatically.

*First Name

*Last Name

*User Email

*Phone

Phone Number must include Country prefix!

Photo

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Birthday

*Company Name

The name of the Company that you represent.

Company Address

Company Email

Company Phone

Phone Number must include Country prefix!

*Club Name

The name of the Diving Club that you represent.

Club Address

Club Email

Club Phone

Phone Number must include Country prefix!

*Partner / Donator Name

The name of the Entity (Institution, Company or else) that you represent.

Partner / Donator Address

Partner / Donator Email

Partner / Donator Phone

Phone Number must include Country prefix!

Membership Number

Membership Start Date

Membership Expiry Date

License Number

Start Date

Expiry Date