USMAA Representative Application

Please print out this form, fill it in completely,
and mail it to:

United States Martial Arts Alliance
2520 Route 22E Suite 9
Scotch Plains, NJ 07076


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
___________________________________________________________________________________ List all that may apply

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:

2520 Route 22E Suite 9
Scotch Plains, NJ 07076

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.