AMAA Foundation Blackbelt Membership Registration

Please fill out the information below. Upon completion, the AMAA Foundation staff will contact you via email with more information.
Name*

First NameLast Name
Phone*
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Birthday (MM/DD/YYYY)*
Website Address (optional)
Social Media Links (optional)
Martial Arts Style(s) and Belt Rank(s)*
Official Martial Arts Title. If none, respond N/A.*
Please select an option(s)*

I'm a school owner.I'm a manager.I'm an instructor.Other
Specify Other Here
If you are a school owner, what is your school name?
School Address?
Year Started Studying Martial Arts*
Years Studying Martial Arts*
Upload one photo of yourself in your martial arts uniform to use for your official welcome announcement. **Full body or waist up preferred***

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Upload your most current martial arts promotion certificate.*

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Terms and Conditions
I do hereby attest the information I have provided is true. I do understand the American Martial Arts Alliance reserves the right to accept or deny any application that is not verifiable. I hereby understand once I have submitted my application all application fees are nonrefundable.
Signature

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My Products
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Blackbelt Membership - One Year
$199.00

Black Belt Membership - Lifetime
$299.00

Subtotal

$0.00

Tax

$0.00

Total

$0.00
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