Joining Form – Ashihara Karate International – Kaicho Hoosain Narker Sabaki Fighting Karate
| APPLICATION FORM (Please print this form) Name/Family Name:_____________________________________________________ Address: _____________________________________________________________________________________________________________________________Telephone: _______________________ Fax: ______________________ E-mail Address:______________________________________________ Date of birth: ____________________ Current Rank: _______________ Karate/Budo Style: ___________________________________________ Grade issued by: _________________ Certificate No: _______________ (Please include photocopy with this application) (Also attach 2 ID size pictures) ORGANISATIONAL INFORMATION: Name of dojo/ club: ___________________________________________________________ Address of dojo/ club: ______________________________________________________________________________________________________________________ Dojo Telephone No: ________________ Fax No: ___________________ E-mail Address: _____________________________________________ No. of Yudansha: ____ No. of Kyu Students: ___ Total No. of Students: ___ (If you have more than one dojo/club affiliated with you, complete the details above and attach a list of the names of the present instructors and the areas of all your affiliated dojo/clubs. Please return to: Ashihara Karate International Kaicho Hoosain Narker, P. O. Box 117, Retreat, 7965, South Africa Fax: +27 21 7011701 E-mail: info@ashiharakarate.org |