APPLICATION FOR MEMBERSHIP:
Enter Information Below please fill in all Blanks. *************************************************************

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

__________________________________________________________________

**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:___________________