THE UNITED STATES MARTIAL ARTS ASSOCIATION INT'L.®
- MEMBERSHIP APPLICATION -

click here to view honored certified members

     

Name:
Address:
 

City:
State:
Zip:

Phone (optional):

Email:
Martial Arts Style:
Current Rank:
Name of Sponsor (Soke or Head of Style):
Date of Birth:
Date of Application:
 
 
 

KINDLY PRINT THIS FORM AND SEND VIA U.S. MAIL WITH PAYMENT
OF $39.00 MADE PAYABLE TO

BILL DeCLEMENTE
P.O. BOX #3473
ABQ., NM 87190-3473