Affiliation application – new members

Affiliation application for

Name *

First

Middle

Last

Date of birth *

Club/Association name *

Dan grade/rank *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email *

Email

Confirm Email

Phone

Website / URL

File Upload

Click or drag files to this area to upload. You can upload up to 5 files.

Please upload your karate CV, photo (passport type) and your last three grading certificates.

GDPR Agreement *

I consent to having this website store my submitted information so they can respond to my inquiry.