AIKA Membership form

AIKA Membership form

    DojoIndividualAIKA Dojo Student
    InstructorAssistant InstructorRank

    Dojo (Covers Dojo & Chief Instructor (Lifetime)) – $25.00
    Individual (Lifetime) – $20.00
    AIKA Affiliate Student (Lifetime) – $15.00 (Must provide proof of affiliation.) Renshi/Kyoshi $25.00 Rank Certificate: Kyu $7.00, Dan $20.00 Instructor’s License: $20.00 AIKA Patch: $5.00

    AIKA affiliated dojo Karate-ka membership request are sent in by the dojo (rank info is still optional)

    ***The following information is not mandatory for membership into the
    A.I.K.A. but is mandatory for Dojo membership, Instructor’s License,
    Certificate of Renshi/Kyoshi and Rank Certificates. A photo copy of rank is
    required for the above certificates***

    Please send check or money order in US currency payable to Phillip Furgason to:

    American Isshinryu Karate Association
    c/o Hanshi-Go Phillip Furgason
    2319 North Durham Drive
    Houston, TX 77008

    *Jr. Grade Instructor’s License does not say Jr. Grade Instructor’s License on the
    certificate – It confers the right to promote all Kyu grades.

    Please allow up to six weeks for delivery