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IKA MEMBERSHIP FEEs:

CLUB MEMBERSHIP FEE: - $100 USD plus $5 USD per student per year.

INDIVIDUAL MEMBERSHIP: - $30 USD per year.

- Club Membership includes a certificate for your dojo and one Yudanshakai Black Belt Membership for the head instructor and membership card for each student.

- Individual Membership includes a membership card only.


IKA Application for Membership

Please fill out the following membership application for consideration by the International Karate Association:

NOTE: Fields that are required are marked with an "*"
If a required field is "Not Applicable" type "NA" in that field.


Your contact information:

*First Name:

*Last Name:

*Middle Initial:

*Address:

*City:

*State:

*Postal Code:

*Country:

*Day Phone:

Evening Phone:

*Email Address:

*Age:

*Rank:

*Style:

*Years Studied:

Comments:

Your instructor's contact information:

Full name with ranks and titles:
Address:
City: State:
Postal Code:
Country:
Phone:
Email Address:


*Do you own your school?
Yes No

*How many schools do you own?

*What type of business is it?

*Is this to be a club or an individual membership?
Club Individual

Tournament History: (Please list dates, names, places, etc.)


Please list three references not affilliated with your school.

Reference #1:
First Name
Last Name Middle Initial
Address
City State
Postal Code
Country
Phone
Email Address


Reference #2:
First Name
Last Name Middle Initial
Address
City State
Postal Code
Country
Phone
Email Address


Reference #3:
First Name
Last Name Middle Initial
Address
City State
Postal Code
Country
Phone
Email Address



© International Karate Association
3301 N. Verdugo Road
Glendale, California 91208
Voice: (818) 541-1240
Fax: (818) 246-0063
E-mail: info@ikakarate.com