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APPLICATION FOR MEMBERSHIP:
Enter Information Below please fill in all Blanks.
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Name:_______________________________________________________
Address:____________________________________________________
City:_____________________________________State:________Zip:_______
Country:_____________Telephone:_________________Email:______________
Date of Birth:__________yr.___________mo.___________day_____________
Martial Arts Affiliation:________________________________________________
Address:____________________________________________________
Your Instructors Name:________________________________Rank:____________
Your style studied:_______________________________________________
How Long:______________________________________________
Your present Rank:_____________________________________
*Please, enclose a copie of your current Certification.
*Please, enclose a passport size picture.
*Associations wishing to Register with the NKKF please, include a copy of your statutes/regulations.
TYPE OF MEMBERSHIP INTERESTED IN:
Individual Membership:_________________________
($40./yr - For those with no school affiliation and wish to continue in their advancement)
Associate School Charter:_______________________
($50./yr - Registers the School or Association only)
Association/School Membership Charter:____________________________
($150./yr - Registers School/Association Instructors and Students)
Comments:______________________________________________
Total enclosed:$________(USD),or Credit Card:
type:____________Number________________exp.date________
(remember to add $7.00 for shipping)
*U.S. Currency (Check/M.O.) or Major Credit Card only Please.
____________________________________________________________
Copy Application and Mail to:
NKKF Karate Dojo Honbu
2611 SW College Rd. Suite # D
Ocala, Florida. U.S.A. 34474
Ph. #(352)237-9076 or Fax:(352)237-2275
Attn. Membership
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**I the above named applicant agree to the terms and covenents of the National Karate & Kobudo Federation. I agree to abide by its bylaws, and to hold harmless all associates, schools, associations, officers, instructors, and members in the event of any loss due to training, or association. I fully understand the dangers of training in the Martial Arts.
signed:____________________________________this day:___________________