New Membership Application 2005-06

edinburgh university shukokai karate club http://shukokai.eusu.ed.ac.uk

APPLICATION FOR NEW MEMBERSHIP 2005/2006 Please complete the application form using BLOCK CAPITALS, and submit to a member of the committee. You will require a passport photograph for your license, but we do not require your photograph with this application form. Name Date of Birth Matric. No. E-mail Address

Faculty UG/PG Year of study

Term Time Address (Please Include Postcode or License Cannot be Applied For)

Mobile

Telephone

Home Address (Please Include Postcode or License Cannot be Applied For)

Telephone Please give details of any previous martial arts experience.

Are you a qualified first-aider? Do you own or have easy access to a car? Please score from 1-10, how important the following are to you, relative of each other: 1. Fitness 2. Sport 3. Self-Defense 4. Just enjoying Karate as a study break

Please give details of any injury or illness of which the instructor should be aware.

[ YES / NO ] [ YES / NO ] Just the one more! Please tell us why you decided to come along to a training session: 1. Information on our website 2. Our stand at the Sports Fair, or a flyer 3. A recommendation by a friend 4. Other:

Chief Instructor: Steven Webster 4th Dan Ao Denkou Jitsu, 2nd Dan Shukokai Karate, 2nd Dan Hontai Yoshin Ryu Ju Jitsu Members of Ao Denkou Kai Scotland, Ao Denkou Kai International, Amateur Martial Association