A.P.I. MEMBERSHIP
APPLICATION
DATE:____________
NAME:____________________________________________
PHONE:_______________________
ADDRESS:________________________________________________
CITY:__________________________________ STATE:___________
ZIP:_________________ E-MAIL:_____________________________
BIRTHDATE:___________________________________
ANY MEDICAL CONDITIONS , MENTAL OR PHYSICAL ILLNESSES THAT MAY AFFECT YOUR TRAINING?
___________________________________________________________
ARE YOU AN INSTRUCTOR OR OWN A SCHOOL?_____________
____________________________________________________________
NAME OF SCHOOL:___________________________________________________
WHAT STYLES?___________________________________________________
WHAT IS YOUR MARTIAL ARTS BACKGROUND?
____________________________________________________________
WHAT IS YOUR INTEREST IN JOINING OUR MEMBERSHIP?_____________________________________________
HOW DID YOU HEAR ABOUT A.P.I.?______________________________________________________
MEMBERSHIP COST PER YEAR: $50
SEND CHECK OR MONEY ORDER TO:
A.P.I. INT'L COMBAT ARTS
5347 NE SANDY BLVD.
PORTLAND, OREGON 97213