DMT Course Registration

Phone

This field is for validation purposes and should be left unchanged.

Diver Medic Technician Course

A $500.00 tuition deposit is required to register for either the Full or the Refresher DMT courses. This amount will be credited towards the total cost. DIT reserves the right to retain tuition deposits for any changes or cancellations made by the applicant less than 21 days from the scheduled class start date. If DIT cancels or changes the course dates for any reason, the tuition deposit will be fully refundable to the applicant.

Course Type*

Full Course

Refresher

Course Date*

Personal Info

Name*

First Last

Company

Email*

Phone*

Address*

City*

State / Province*

ZIP Code

Country*

SSN*

Social Security Number required if U.S. Citizen.
Your SSN is transmitted and stored securely.

Will You Be Using Veteran Benefits to Fund the Program?*

Yes

Certifications & Experience

IMCA-recognized Offshore Certification

Level

Issued By

Date Issued

Date Expires

IMCA certification/registration number

Emergency Medical Training

* Only required for NBDHMT certification. Must be above the Emergency Medical Responder (EMR) or Basic First Aid level.

Level

Issued By

Date Issued

Diving Physical / Medical Exam

Are you current?

Issued By

Date Expires

Diver Medic Certification to be renewed

Issued By

DMT Cert. No.

Date Issued

Date Expires

Other Certification / Document

Certification / Document Name

Level

Issued By

Date Issued

Date Expires

Dive School

Dive School Attended

Graduation Date

DMT Certificate

Full Name To Appear on DMT Certificate*

Date of Birth*

Product Name

DMT Course Registration Fee

Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Credit Card*

DMT Course Registration

Diver Medic Technician Course

Personal Info

Certifications & Experience

IMCA-recognized Offshore Certification

Emergency Medical Training

Diving Physical / Medical Exam

Diver Medic Certification to be renewed

Other Certification / Document

Dive School

DMT Certificate

Let's Get Started