This document is an application form for Ivan Vasilev from Bulgaria to have his diving certificates assessed and recognized in the Netherlands. He is applying for the Dutch Certificate and has done all of his diver training courses in an EU country. He is providing copies of his relevant diving certificates, logs, medicals and passport. He is seeking assessment and recognition for several categories of commercial diving including SCUBA diving up to 30 meters, surface supplied diving up to 50 meters including wet bell experience, and closed bell/saturation diving. Details of his training and experience are provided for each category.

1. APPLICATIONFORM ASSESSMENT DIVING AT WORK TRAINING CERTIFICATES
COMPLETE AND RETURN TO:
NDC CI, Buitenhofdreef 280, 2625 RE DELFT, the Netherlands
V Please tick when appropriate
PERSONAL DETAILS
Family name:
VASILEV
Given name(s):
IVAN IVAYLOV
Address:
KRUM BACHVAROV BL 16 VH 2 AP 45
Postal code & Place:
3700 VIDIN
Country
BULGARIA
Phone:
00359886433551
E-mail:
DIVE_SURVIVE@ABV.BG
Date _ place & country
of birth:
5th
DEC 1977
Nationality:
BULGARIAN
VAT-number:

2. Send invoice to (please fill in address if different from “personal details”)
Holder
[] Applies for Statement of Equivalence (40 days work per year) with a duration of 1 (one) year
[V] Applies for the Dutch Certificate (theoretical/practical exam conform certification scheme)
[] has done his diver training course outside the EU
[] has done his diver training courses outside the EU and inside the EU
[V] has done all his diver training courses in a EU country
Herewith the holder sends:
• Statement of good conduct (Police certificate for immigration purposes)
http://www.government.nl/issues/certificates-of-good-conduct
• Copies/scans of relevant diving certificates
• Copies/scans of relevant dives logged during the training course (don’t forget the first page with
photo, personal details, signature and the page numbers must be readable)
• Copies/scans of dives logged during the preceding 24months to demonstrate that holders meets
the equivalence and/or working experience. (don’t forget the first page with photo, personal details,
signature and the page numbers must be readable)
• Copies/scans of diver medicals (2/3 pieces) *)
• Copies/scans of passport
*) In the Netherlands only diving medical issued by HSE or Dutch recognized diving doctors
(physicians) are allowed to use in the Dutch Sector. So when you start working in the Dutch Sector
you need one of these kind of diving medical
See www.hse.gov.uk/diving/medicalpractitioners.pdf
Your application will be processed after receipt of your payment!
 Training course info:
when holder has no
certificate issued by HSE,
PDC, ADAS, DCBC or
Norway
 school brochure / leaflet
 school training programme
 textbooks
 syllabi

3. CERTIFICATE(S) TO BE ASSESSED
 Duikarbeid Categorie A1 = Diving with SCUBA 9 mtrs
Diving in aquaria
 enclose copy of certificate
 Duikarbeid Categorie A2 = Diving with SCUBA 15 mtrs
fire brigade divers / car salvage
 enclose copy of certificate
 Duikarbeid Categorie A3 = Diving with SCUBA 30 mtrs
Inshore
 enclose copy of certificate
Category A (SCUBA) is an entrance requirement for Category B (SSE) So please forward also
your SCUBA certificate(s) and provide details of your SCUBA training and/or experience
 Duikarbeid Categorie B1 = Diving with SSE 15 mtrs
fire brigade divers
 enclose copy of certificate
 Duikarbeid Categorie B2 = Diving with SSE 30 mtrs
inshore
 enclose copy of certificate
 Duikarbeid Categorie B3 = Diving with SSE 50 mtrs
including tools training
offshore
 enclose copy of certificate
V Duikarbeid Categorie B4 = Diving with SSE 50 mtrs
including tools training and
wetbell offshore
enclose copy of certificate
 Duikarbeid Categorie C = Closed Bell / saturation diving  enclose copy of certificate
DETAILS OF SCHOOL More schools / more details
Name of school(s)
The Underwater Centre
Address(es)
Fort Williams
Postal code & place
Marine Walk, Carmichael Way, Fort William PH33 6FF
Country
UK
Member of IDSA (International Diving Schools Association) (yes / no)
Contact person
Phone
0044 1397 703786
E-mail address
fortwilliam@theunderwatercentre.com

4. The undersigned
• has read the brochures sent
• pays the amount due on receipt of invoice. Your application will be processed after
receipt of payment;
• has taken note of – and agrees with – the applicable conditions, which are considered to
be herein repeated and inserted verbally;
• has answered all relevant questions in this application form completely and truthfully.
Date Place Signature
23/10/2
014
Bulgaria Ivan VASILEV
NOTE
If you are applying for Dutch Diving Category B4 (Surface Supplied till 50 m including tools
training and wetbell module and/or Assessment for the Dutch Diving Category C (Closed
Bell/saturation): then the following is applicable:
When your certificate(s) is/are issued by the Underwater Centre (including HSE), PDC Durban or
INPP, ADAS, DCBC or Norway and the certificates were obtained by following a complete
diving training course (SCUBA, SSE and TOP UP) then you don’t have to fill in the complete
form. We know the training standards of these courses.
When you send the filled in application form you will receive a confirmation of receipt within
two weeks with further information and details about payment (invoice)
Your application will be processed after receipt of your payment!
Don’t forget to send scans/copies of the documents needed for the assessment.

5. You are expected to show for SCUBA the following training and/or work experience:
• depth till 15 metres: at least 1580 minutes total dive time,
• depth from 15 till 30 meter: at least 360 minutes total dive time, including a dive till a
depth of more than 28 metres.
DETAILS OF TRAINING
SCUBA Diving
Total duration of course
Diving minutes
Number of hours theoretical
instruction
Training
…………………….. hours in ………………. weeks
< 15 metres: …………………………………minutes
15-30 metres: ………………………..………. minutes
# dives > 28 metres: …………………………...……
………………………………………………... hours
SCUBA Diving
Diving minutes
work experience
< 15 metres: …………………………………minutes
15-30 metres: ………………………..………. minutes
# dives >28 metres: …………………………...……

6. You are expected to show for SSE & Offshore Top Up the following training and/or
work experience
• depth between 30 and 40 meter: at least 120 minutes total dive time
• depth between 40 and 50 meter: at least 170 minuten Total dive tuim of which at
least three dives in open water with a total combined bottom time of at least 75
minutes.
• Wetbell dives (as diver and bellman) including emergency procedures
• SCUBA is an entrance requirement for Category B (SSE) so please provide details of
you SCUBA training and/or experience
• Total dive minutes SCUBA & SSE 2230 minutes
Surface Supply diving Training
Total duration of course
Diving minutes
Number of hours theoretical
instruction
…90………………….. hours in ……………3…. weeks
< 15 metres: …………………………………minutes
15-30 metres: …………………………..… minutes
30-40 metres: …………………………..… minutes
40-50 metres: - total dive time………...…… minutes
- total bottom time ……………….minutes
………………………………………………... hours
Surface Supply diving
Diving minutes
Experience with hotwatersuit:
Work experience
< 15metres: ………1629…………………………minutes
15-30 metres: ………1645…………………..… minutes
30-40 metres: ………2143…………………..… minutes
40-50 metres: - total dive time……157…...…… minutes
- total bottom time ……………….minutes
Yes ……………………50……………... times

7. Wetbell diving
Total duration of the course
Number of wetbell dives
Training
………….2................ hours in ……......3......…… weeks
………6……........................................................dives
Wetbell diving
Number of wetbell dives
Work experience
……………........................................................dives
For Assessment Category C (Closed Bell / saturation)
Deep diving (only to fill in when you have not done your Closed Bell training at INPP or
The Underwater Centre)
Total duration of course
number of bounce dives
Number of saturation dives
Number of lockouts
Number of Transfers under
Pressure
Number of hours theoretical
instruction
…………………….. hours in ………………. weeks
to 55 metre: ……………………………………….…… dives
to 75 metre: ………………………………………….… dives
to 100 metre: ……………..………………………….… dives
……………………………… dives
…………………………..….. lockouts
……………………………… TUP’s
…………………………….... hours

8. THEORETICAL TRAINING
Physics number of hours: ………10…………………..………..
Physiology number of hours: …………10………………..………..
Decompression number of hours: ……………10……………..………..
Diving sicknesses number of hours: ……0……………………..………..
Diver First Aid number of hours: ………10…………………..………..
TRAINING IN USE OF UNDERWATER TOOLS
 During diver training
 In separate module  enclose copy of certificate
Details of tools used in working experience
Mechanical tools - all
Hydraulic tools - DKR
hole drilling; concrete
and steel cutting;
waterjet; impact wrench;
hydraulic jack; stanley
hydraulic uw breakers;
magnetic handle;
magnetic handle; stanley
impact drill;
diamond chain saw;
hydraulic core drill; drill
rig column; hydraulic
hummer
Electrical tools –
airlift;brocco; welding
machine;
number of hours ……all the
time……….
number of hours ………all the
time…….
number of hours ………all the
time…….
 enclose list of tools used
 enclose list of tools used
 enclose list of tools used