APPLICATION FORM

YOUR FULL NAME & DATE OF BIRTH

YOUR FULL ADDRESS, PHONE NUMBER AND POST OR ZIP CODE

YOUR GRADE, RANK AND POSITION IN ORGANISATION

YOUR LOCATION

YOUR EMAIL ADDRESS

YOUR WEBSITE ADDRESS

YOUR DOJO'S NAME(S)

NUMBER OF DOJOS

LIST YOUR DOJOS NAME AND CITYS IN FULL

LIST NAME GRADES OF BLACK BELTS IN YOUR ORGANISATION (list N/A if none)

DO YOU TEACH THE DOJO KUN

DO YOU USE A KYOKUSHINKAI SYLLABUS

LIST THE ORGANISATIONS SYLLABUS

WHAT MEMBERSHIP WOULD YOU LIKE

UK ONLY (DO YOU HOLD A CRB)

UK ONLY (DO YOU HOLD INSTRUCTORS INSURANCE

UK ONLY (UK DOJO'S MUST USE STUDENTS UNION INSURANCE ARE YOU WILLING TO USE!

PLEASE LIST ANY OTHER INFOMATION TO HELP WITH YOUR APPLICATION & MEMBER TO E MAIL YOUR DAN GRADE CERTIFICATE AND UPLOAD A PHOTO TO THE WEBSITE

PLEASE TICK WHAT SERVICES YOU ARE PAYING OR DONE

KYOKUSHIN SCHOOLS OF KARATE