Membership Application Form printable pdf download

MEMBERSHIP APPLICATION FORM

TANG SOO DO GENERAL FEDERATION MOO DUk kWAN

#240, Ssanglim-Dong, Joong-Gu, Seoul Korea | TEL. 82-2-2285-1146 | FAX. 82-2-2275-1443 | |

Region Name: ____________________________

Club: __________________________________

MR/MRS/MISS FULL NAME _______________________

SURNAME __________________________

ADDRESS ___________________________________________________________________________

CITY _______________STATE ___________________ ZIP_ ___________________________________

DATE OF BIRTH ___________ AGE _____ OCCUP_ATION ___________________________ SEX ______

TEL. ____________________________

EMAIL __________________________________________

Have you had any practice before in martial Arts? YES/NO

P_resent Grade ______________________________________

If yes, state belt ____________________________

Association/Club Name ________________________________

Do you suffer from any disease, illness or other physical or mental disorder which might be or become aggravated by

the practice of Tang Soo Do and Tae Kwon Do or which might expose you others to risk?

YES/NO (if yes, please state) ____________________________________________________________________________

Have you ever been convicted of a crime of violence? YES/NO

if yes, give details ____________________________________________________________________________________

* Please enclose 4 passport sized photographs

DECLARATION 1 (FOR NEW APPLICATIONS)

I __________________________ the undersigned, wish to apply for membership in the Federation. I hereby agree to abide by the

Rules and Regulations of the Federation. I declare that to the best of my knowledge and belief, the information given in this application is correct.

Signature of Applicant

_________________________________

Date _____________________________________

DECLARATION 2 (RENEWAL OF MEMBERSHIP)

I __________________________ the undersigned, wish to apply to renew my membership in the Federation. I hereby agree to

abide by the Rules and Regulations of the Federation. I declare that to the best of my knowledge and belief, the information given in this

application is correct.

Signature of Applicant

______________________________ Federation No. _______________

Date of Expiry _____________

PART C

For junior member under 18 years old

I __________________________ the undersigned, hereby give consent toto apply for membership with the World M. D. K. General

Federation M. D. W. I declare that to the best of my knowledge and belief the information given in this application is correct.

Signature of P_arent/Guardian ______________________________

Date _________________________________

PART D

Recommendation

I __________________________ the undersigned, hereby recommend the above named to be a member of the World M. D. K. General

Federation M. D. W.

Signature of Instructor

_________________________________

Date _____________________________________

REGIONAL USE ONLY

FEDERATION USE ONLY

FEDERATION STAMP

Membership Fee __________________________

Date of Approval/Rejection ___________________

Date P_aid _______________________________

Fed. No. Issued ___________________________

Collecting Officer Name _____________________

Fed. No. ________________________________

Secretary General Signature __________________

IMPORTANT: If you change your address or Telephone number, Please let us know immediately in writing to the Secretary General. K. W. Chong

Direct. 010-6279,7807 |

Membership Application Form

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