ࡱ> 796 bjbj 4$y  8(,Tu pppppKKK,!"$r KKKKK +pp/ +++Kvpp+K++Vh@brj E 0u TE%+E%+KKK  +KKKu E%KKKKKKKKK  :   UMAINE Scientific DivER APPLICATION Candidate: _________________________ Date of Issue: ___/___/___ Supervisor: _________________________ Date of Expiry: ___/___/___ Temporary Diver/ Diver in Training Requirements Copy of Certification Card Medical History Date:___/___/___ Medical Exam Date: ___/___/___ Diver Information Sheet Date:___/___/____ Regulator Service Date: ___/___/___ 91 Orientation and Quiz Date: ___/___/___ Liability/Insurance/Employment Forms Date: ___/___/___ Checkout Dive Date: ___/___/___ Scientific Diver/Lead Diver Requirements Diver In Training requirements met Date: ___/___/___ CPR Date: ___/___/___ First Aid Date: ___/___/___ Oxygen Administration Date: ___/___/__ Scientific Diving Written Exam Date: ___/___/___ Rescue Diver Date: ___/___/___ DOT HP Cylinder Training Date: ___/___/___ 100hr. Scientific Diving Course Date: ___/___/___ >12 Dives (in last 12 months) # Dives: ____________ Dive Computer Authorization Date: ___/___/____ Depth Authorization (circle one) 30ft. 60ft. 100ft. 130ft. >130ft. Certifications Issued: AOW ________ ( Scientific- AAUS ________ Rescue - _______ Other: _____)______________ Completion of this application verifies that the aforementioned diver candidate has successfully met the documentation and training requirements as stated in the University of Maine Standards for Scientific Diving Certification and Operation of Scientific Diving Programs. As such, this individual may participate in sanctioned diving activities at 91 at the level of: Temporary Diver Diver In Training Scientific Diver This application is valid for the period indicated (not to exceed 12 months) at which time the divers credentials must be reviewed. Candidate: X___________________________________ Diving Safety Officer: X___________________________________ Christopher Rigaud, 91 Diving Safety Officer     91 Diving Control Board has developed this application to comply with the requirements for scientific diving established in the University of Maine Standards for Scientific Diving Certification and Operation of Scientific Diving Programs and in accordance with applicable national guidelines for scientific diving established by the American Academy of Underwater Sciences (AAUS). This application is valid only for the time period indicated and only for scientific diving operations conducted under the auspices of the University of Maine. It does not eliminate or reduce any requirements of diver training, conduct, or documentation and should not be used as the sole source of information regarding a divers qualifications, training record, or current 91 diver status. 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Courier New7CalibriACambria Math"Ah&&gJ&'!t !t !243Q HP?D>u2!xx UMAINE Chris RigaudChristopher Rigaud    Oh+'0  8 D P \hpx'UMAINEChris Rigaud Normal.dotmChristopher Rigaud5Microsoft Macintosh Word@^в@@dtѧ9@DnLr!t ՜.+,0 hp  'University of Maine  UMAINE Title  !"#$%'()*+,-/0123458Root Entry F$R:br:1Table]%WordDocument4$SummaryInformation(&DocumentSummaryInformation8.CompObj` F Microsoft Word 97-2004 DocumentNB6WWord.Document.8