HAKKORYU MARTIAL ARTS FEDERATION
REGISTRATION FORM

HMAF Fees:
Annual dojo membership fee $30
Annual renewal fee per student $30

Name
Street
City State Zip

Phone
Email


If renewal, current HMAF number:

Date of Birth
Place of Birth
US Citizen? yes no
Occupation

Dojo Name
Dojo Address
Dojo City State Zip
Head Instructor

Current HMAF Rank

List of All Other Ranks:
(rank & date granted, style, primary instructor)

Please print this form. Mail it to:
Dara Masi, Shihan
Suigetsu Dojo
80B Broadway
Greenlawn NY 11740

Make your check out to "Suigetsu Dojo".
Write "HMAF Dues" on the Memo line.