MEMBERSHIP APPLICATION

Name:__________________________________________                     4-Photo's:

Address:________________________________________

City:________ State:____________ Zip:_______________

Apt:________ Sex:_________ Age:_______

Home Phone:_____________  Date Of Birth:____________ 

Email Address:____________________________________

What is your Website URL:_________________________________

Are You A Member Of Any Organization: _______________________________________________________

If Yes, Give Registration Number:________________________

School / Dojo: _______________________________________________

Martial Arts History: ____________________________________________________________

Please Give Us The Following Information;

Inst. Name,_____________________________________________                           Remarks:

Title,______________________________________________

Rank Of your Instructor.______________________________

What is Your Rank Obtained From School/Dojo:_________________________________________________

Years Of Study:____________ Date Of Rank:________________

Weapons Proficient In: _______________________________________________________________________

Knowledge And Ability:                                               Physical Shape:

[ ] Excellent: [ ] Good: [ ] Fair: [ ] Poor:                        [ ] Excellent: [ ] Average: [ ] Fair: [ ] Poor:

Membership Status:  { Please Check }.

[ ] Non-Refunderble Yearly Membership Renewal, for year (             ) Fee: $65.00/USD 

[ ] Bodoki Ryu Ninjitsu Representative / would like to run your own dojo under Bodoki Ryu.

[  ]  under rank membership. 

[  ]  black belt membership.  ( we need a copy of your rank )...

Attention:  please make a copy of the following, this membership application, the disclaimer form, and the bodoki ryu ninjitsu bi - laws. and send with your Non-Refunderble Registration Fee and rank fee. also send in your rank certification to us. you must sign all paperwork. send to our main office: Bodoki-Ryu Ninjitsu Dojo P.O.Box: 535, Bronx, New York. 10451-0535 we will add your name,  on our website if you are approved. all payments payable to soke: angel m. guerra USD / postal money orders only.

sign below: 

I______________________________hereby submit that the information verifiable certification of that rank from a credible school or organization. 

signed:_________________________________________date:____________