Applicant Name: _________________________________School Name: _____________________
Telephone: ______________ Fax: _______________ E-mail: _________________ School Web-Site:_________________
Street Address: _______________________________________________________
City: ______________________________ State: _______ Zip Code: __________
Country:______ Birth date: ____________ Sex: ________ Uniform Size: ________
Height: ________ Weight: ________ Martial Art Rank(s) Achieved: ________ ________ ________ ________ list all
In Business Since: ________________ Number of locations: ________ Number of Instructors Employed: ________ Total # of students: ________
Last Association you were a member of: ________________
Please list your area(s) of expertise: example; plyometrics, stretching, management, organization, event planning, TKD, Jui-Jitsu, etc
Please explain how you would best assist the USMAA: ___________________________________
What are your main reasons for becoming a USMAA Representative? _______________________________________________________________________
Before submitting this application to the USMAA Headquarters, we strongly recommend visiting the USMAA web-Site and thoroughly reading our mission statement and vision page. Upon approval of this application you must personally meet with Master Serdinsky and share your thoughts and reasons for involvement. Master Serdinsky is committed to providing the finest quality Martial Arts instruction available today. This is the USMAA's primary mission. Instruction/Certification/Business Management/ Competition through our affiliate organizations
Thank you for your interest in the USMAA. We welcome you to our family, and look forward to sharing our wealth of knowledge with you.
Print Name: ___________________________ Sign Name: ________________________ Date: _______________
Please the completed application to the address below:
The USMAA has the right to refuse or cancel any membership due to any misconduct, in the eyes of the USMAA, and/or noncompliance with the terms and conditions set forth herein.