Print Out, Fill Out and Fax or mail to:
ProSEA
P.O. Box 320057
Tampa, FL 33679-2057 FAX: (813) 876-1777

Member (or Institutional) Name: ___________________________________________

Nominated By:_________________________________ Date:___________________

Type of Membership (please check one):

__ Individual Member: $750.00 per year
     Allows one (1) voting membership and participation of one person in ProSEA activities.

__ Corporate or Institutional Member: $1,500 per year
     Allows three (3) voting memberships and participation of three people in ProSEA activities.

__ Associate Member: $175 per year
     For Companies and Individuals who provide services to ProSEA Members.

Make checks payable to: Professional Shipwreck Explorer's Association Inc.
Mail checks to:
                        ProSEA
                        P.O. Box 320057
                        Tampa, FL 33679-2057

Institutional Names (3) :

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

Address:_________________________________________________________________

City:________________________________ State:_________________ Zip:___________

Country:____________________

Phone:_______________________ Fax:_______________________

E-mail:_____________________________Website:_______________________________

Past Shipwreck Expedition Involvement or Interests:

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

(Please include resume, publications or other documentation relating to your shipwreck exploration activities)

Name:______________________________________

Signature:_______________________Date:________