INTERNATIONAL SUNGJADO ASSOCIATION

MEMBERSHIP APPLICATION

This form is for MEMBERSHIP application only!! If you are a BLACK BELT in any martial arts, then you have to provide this proof: Copy of rank certification for all black belt ranks EARNED, no cross-ranks. You must include a 2" x 2" passport size photo for membership. Send an e-mail with your photo attached, and don't forget your name with it.

FIRST NAME:

LAST NAME:

ADDRESS:

CITY:

STATE/PROVINCE/COUNTY:

ZIP_POSTAL:

TELE:

E-MAIL ADDRESS:

SEX:

CURRENT HIGHEST RANK YOU CAN VERIFY:

DATE OF RANK: MM/DD/YY

CURRENT COLOR OF BELT:

YOUR MAIN STYLE:

INSTRUCTOR'S NAME:

INSTR. ADDRESS:

INSTR. CITY/STATE/ZIP:

YOUR INSTRUCTOR'S TELEPHONE #:

YOUR BIRTHDATE: MM/DD/YYYY

AGE:

INTERNATIONAL SUNGJADO ASSOCIATION MEMBERSHIP APPLICATION

INTERNATIONAL SUNGJADO ASSOCIATION

MEMBERSHIP APPLICATION