Associate Membership Form

Associate Membership State / District / Club Form

Name of the Representative:

Name of the International/National Organisation if any:

Name of the Style (Shoto / Shito / Goju / Wado / Others):

Present Style Grade Dan:

Date Of Birth

Number of years in Martial arts:

Number of Students:

Number of years in Coaching:

Number of Dojos:

Instructors under you:

Part Time / Full Time

History of Training, Education, Awards etc.

Correspondence Address:

State:

Pin code:

Mob. No.

Email id

UNDERTAKING

I/We hereby declare and confirm that this information furnished by me are true and grant of approval by WFSKA INDIA is subject to abiding by the rules regulations terms and conditions followed by me and my instructors / students. I agree to conduct karate classes / seminars as per the guidelines of WFSKA INDIA. I agree that I shall participate in all the events conducted / hosted by WFSKA INDIA for the development of karate in the interest of my students. I understand that the request for the renewal of the approval would be required to be made by a fresh application once expired.

I understand and accept that WFSKA INDIA has the rights to cancel the recognition granted to me at any time incase of me or my association / style involve in any antiassociation or anti WFSKAI / KIO / WKF / TKAG Karate Do activity.

Date

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