American Karate Academies National Association
Renewal Payment Form
Name:
*
Will be printed on your certificate
Dojo:
*
Chartered dojo you are applying under
Style:
*
Will be printed on your certificate
Title:
*
Please Select
None
Senpai
Sensei
Tashi
Renshi
Shihan
Kyoshi
Hanshi
Sifu
O'Sensei
O'Shihan
Age:
*
Time-in Training
*
Years
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
AKANA Verification Code
example: NC-001-002-YM (located on certificate)
T-Shirt Size
*
Please Select
Youth M
Youth L
Adult S
Adult M
Adult L
Adult XL
Adult 2XL
Adult 3XL
File Upload
Browse Files
Drag and drop files here
Choose a file
Optional: Updated picture in uniform with AKANA patch (full body)
Cancel
of
If applying for multiple renewals, please list their name, rank, t-shirt size, and AKANA verification number in the box below.
My Products
*
prev
next
( X )
AKANA School Charter Renewal
Paid annually from the date payment is processed. Includes an individual membership card recognizing rank and style with the respective patch.
$
350.00
AKANA Individual Black Belt Renewal
Paid annually from the date payment is processed. Includes an individual membership card recognizing rank and style with the respective patch.
$
100.00
Quantity
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Item subtotal:
$
0.00
AKANA Mudansha Kyu-rank Membership
Paid annually from the date payment is processed. Includes an 8.5x11 membership certificate recognizing rank with the respective patch. Three levels: Beginner (10th-7th Kyu), Intermediate (6th-4th Kyu), Advanced (3rd-1st Kyu).
$
50.00
Quantity
Beginner Membership
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Intermediate Membership
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Advanced Membership
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Item subtotal:
$
0.00
loading smart payment buttons...
The payment is ready! It will be completed once you submit the form.
Submit
Should be Empty: