NOTE: Potential applicants who are completing this application on-line.
You must first pay the required fee of $35.00 using the PayPal option on the PROSHOP page; make sure you have the PayPal confirmation code written down so you can complete this form.
Tactical Hapkido Alliance Individual Membership On-Line Application:
First Name:
*
Last Name:
*
Address:
*
City:
*
State:
*
Zip Code:
*
Country:
*
Home Phone Number:
*
Work Phone Number:
Date of Birth:
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Month
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Day
Year
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2
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:
Hour
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10
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50
Minutes
AM
PM
AM/PM Option
Email:
*
Occupation:
Your Martial Arts Background:
Art/Style:
*
Rank:
*
Name of your School:
*
Address of your school:
School's Phone Number:
City:
State:
Zip Code:
Country:
Name of Instructor:
*
Instructor's Rank:
Your PayPal confirmation code:
*
Submit My Application
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