The United Isshinryu Karate Association (UIKA) is made up of Isshinryu practitioners who have a sincere interest in practicing kata and bunkai in the way Grandmaster Tatsuo Shimabuku taught via his senior american student Master Harold Mitchum. The UIKA currently produces several news/information letters per year. The UIKA also provides an annual Clinic and Promotional Board Meeting open to the entire membership. The current membership fees are: Annual - $25.00 Life - $200.00 NEW!! Five year - $100 To join the UIKA, fill out the membership application form and mail it to the address on the form with the appropriate fee. The UIKA reserves the right to deny membership - in which case the fee will be refunded in full. |
|
| Membership Info |
(Please Print All Information) NAME________________________________________________________________ RANK__________________________ AGE_____________ DATE OF BIRTH _________________________ SEX _____________ PHONE _________________ HOME ADDRESS_____________________________________________________________________ CITY_________________________________________ STATE______________ ZIP _______________ E-MAIL ADDRESS_____________________________________________________________________ NUMBER OF YEARS STUDYING ISSHINRYU KARATE ___________________________________________________________________ NAME OF DOJO AFFILIATION ____________________________________________ DOJO ADDRESS ______________________________________________________ CHIEF INSTRUCTOR___________________________________________________ RANK___________________________ ISSHINRYU KARATE HISTORY (Use Reverse Side if Necessary) RANK DATE PROMOTED NAME,RANK, AND ADDRESS OF PROMOTING OFFICIAL ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ PERSONAL HISTORY PROFESSION OTHER THAN KARATE _____________________________________________________________________ BUSINESS ADDRESS _____________________________ PHONE ________________ MARITAL STATUS MARRIED ______ SINGLE _______ SPOUSES NAME _____________________________________ MILITARY RECORD: BRANCH OF SERVICE __________________________ PERIOD COVERED ____________________ REFERENCES: LIST TWO WHO ARE ISSHINRYU KARATE PRACTITIONERS. 1. _________________________________________________________________________________________ 2. _________________________________________________________________________________________ 3. _________________________________________________________________________________________ SIGNATURE OF APPLICANT ____________________________________________ DATE ___________________ PLEASE ENCLOSE: MAIL APPLICATION & CHECK TO: Copies of Rank Certificates (Only Sho Dan & Higher) $25.00 . One Year Membership Fee U.I.K.A. $200.00 . Lifetime Membership Fee 15222 HAYS ROAD Make Checks payable to U.I.K.A. SPRING HILL, FL 34610 |
| UNITED ISSHINRYU KARATE ASSOCIATION MEMBERSHIP APPLICATION |