Name of Applicant: ____________________________________________________
Address: _____________________________________________________________
e-mail address: ________________________________________________________
Age/Health Status: _____________________________________________________
Position Desired/Skills to Contribute: _____________________________________

1.) How many:
a) closed circuit rebreathers (any type) have you made? ________________________
b) semi-closed circuit rebreathers have you made? _____________________________
c) hours of dive time do you have on:
----- c.1.) homemade semi- and/or closed circuit rebreathers? ____________________
----- c.2.) commercial and/or military rebreathers (any type)? _________________________
------c.3.) open circuit SCUBA ? ____________________________________________
d) total number of dives. __________________________________________________
e) rebreathers have the various manufacturers promised to produce over the past few years, and have yet to deliver?____________________________________________________

2.) Have you ever:
a) violated Boyles law? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes/No
b) violated the no decompression limits?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes/No
c) modified a scuba regulators? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes/No
d) . . . if Yes, what modifications have you made?________________________________
e) dived solo? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes/No
f) . . . if Yes, when you dived Solo, were you by yoursef?. . . . . . . . . . . . . . . . .. Yes/No
g) used a full face mask?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes/No
h) used a dry suit? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes/No
i) used underwater communication gear? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes/No
j) had to participate in buddy breathing NOT in a training situation? . . . . . . . .Yes/No
k) purposely sucked a scuba tank empty at depth, just to see if you can get another breath or two out of it during the ascent? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes/No
l) . . . did it work? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes/No
m) consumed game underwater ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes/No
n) tasted SodaSorb or Sofnolime? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes/No
o) discharged a firearm underwater? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes/No
p) filled a scuba tank? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes/No
q) over-filled a scuba tank? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes/No
r) used the partial pressure method of mixing gasses in a tank?. . . . . . . . . . . . . .Yes/No
s) placed a limpet on a friends boat without their knowing, just for the fun of it?. Yes/No

3.) Can you:
a) solve the semi-closed equation? . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes/No
b) free dive? . . . . . . . Yes/No________ Have you ever paid to free dive?. . . . . . .Yes/No
c) enter/exit the beach through 5+ foot surf conditions with full SCUBA? .. . . . . . Yes/No
d) enter/exit rock ledges during 5+ foot surge conditions with full SCUBA? . . . . . Yes/No
e) perform an ESA? . .Yes/No______ If yes from what max. depth: _______________ fsw.
f) use a speargun? . . . Yes/No______ What type: .. Band.. /.. Pneumatic.. /.. Cartridge..
g) pilot a small boat? . Yes/No______ Navigate using: . .Radar.. /.. GPS.. / Sextant / DR
h) operate machines?. .Yes/No______ Type: ..Lathe.. /.. Mill.. /.. Plasma Cutter.. /.. M60

4.) Do you:
a) want to be part of cutting-edge sub-aquatic technological advancements? . . . . . Yes/No
b) want participate in diving history? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes/No
c) want to go where no diver have gone before? . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes/No
d) really want to live forever?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes/No

(Answer Yes to any of the above, and you may have what it takes to become a member of the CEDU.)
(Answer No to select questions, you definately have what it takes to become a member of the CEDU.)

Submission of this application is in itself no guarantee that I will be accepted into the CEDU. I (print name) _________________________________ understand that CEDU membership is conditional upon passing various minimum entry requirements and continual membership is completely at the discretion of the Director. I hereby certify to the best of my knowledge that the above information is correct, and I understand that if accepted, I WILL NOT Confirm or Deny, not only my Membership IN, but the Very Existence OF the CEDU.

Respectfully submitted (signature)_________________________________ Date ________

( For email return: Copy the form to your clipboard, paste it in your word processor, answer the questions, again copy to your clipboard and paste form with answers into an email to me at doctrbob@gte.net . You knew how to do that didn't you. And I bet you even know what to do with the Yes/No questions. For snail-mail return: Print out this form, complete it, and mail it back to the address provided.)