Universal Fighting Arts Federation Application

UNIVERSAL FIGHTING ARTS FEDERATION APPLICATION

INDIVIDUAL APPLICATION FOR MEMBERSHIP (Please fill out neatly)

* We can also send you information about video testing, critiquing, and instruction if you request that as well.

Date: ________

_____ * Please send me additional information to enroll my school or to start a study group

NAME:__________________________________________________________________

________________________________________________________________________

CITY: ________________________ STATE: __________________ ZIP:______________

EVENING PHONE (_________) ______________________________________________

E-MAIL ADDRESS: ________________________________________________________

WEBSITE IF YOU HAVE ONE: ______________________________________________

BIRTH DATE: ______________________

OCCUPATION:___________________________________________________________

MARTIAL ARTS STYLE: ___________________________________________________

YEARS EXPERIENCE: _________

________________________________________________________________________

RANK EARNED (IF ANY): ________________________________________________________________________

Name of School: ___________________________________________________________

For those renewing membership, please list your old membership number here: __________________________

Signature of parent (if applicant is a minor):

____________________________________________________________________

Sifu Richard Mieir-King

UNIVERSAL FIGHTING ARTS FEDERATION
King's Studio's Supplies, and Seminars
Sifu Richard Mieir-King