Full Name
*
Grade
*
Name of club or association
*
Email
*
Telephone Number
*
Please upload a copy of your latest Dan Grade certificate
*
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Please upload a copy of your licence book and dates of grades
*
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What is the name of your club
*
Website
*
Would you like us to promote your club name and website on our members page.
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Select an option:
Yes
No
*
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