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BUDOKAIKAN INTERNATIONAL
MEMBERSHIP APPLICATION

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RANK RECOGNITION/MEMBERSHIP APPLICATION



  1. Name:______________________________________________________
    Address:___________________________________________________
    City:_______________________ State:________ Zip:_________
    Home Phone:_________________ Work:_____________ Ext:_____
    DOB:____________ Sex:______ Height:_________ Weight:____
  2. Current Rank:_______________ System:______________________
    Dojo:______________________________________________________
    Address:___________________________________________________
    Sensei:__________________________ Sensei's Rank:___________

3. Please give us your Martial Arts Rank History:


 


 


 


4. I am seeking the following Certifications/Licenses:


___Annual Membership $35 (includes Certificate, ID Card & Patch)


___Life Membership $150 (includes Certificate, ID Card & Patch)


___Kyu Grade Certification $25 per Kyu Grade (includes Certificate & ID Card)


___Black Belt Certification (Shodan $100; Nidan $125; Sandan $150; Yondan $175; Godan $200; Rokudan $225; Shichidan $250: Hachidan $275; Kudan $300; Judan $325)(includes Certificate & ID Card)


___School Charter $50 Annual $125 Lifetime (includes Certificate)


___Instructor Certification $50 Annual Fee (includes Certificate & ID Card)(Must possess a minimum rank of Sandan)


___Master Instructor Certification/License (Renshi $300; Shihan $350; Menkyo Kaiden $400; Kyoshi $400; Hanchi $450)(Minimum rank of Godan for Renshi, Menkyo Kaiden; minimum rank of Rokudan for Shihan; minimum rank of Shichidan for Kyoshi; minimum rank of Hachidan for Hanchi)(Master Instructor Certifications are Lifetime Registration & Recognition)


___Budokaikan International World Sokeship Council (Soke $450 must be Godan or higher and provide proof of inheritorship; Soke Dai $500 must be Kudan or higher and provide proof of inheritorship; Sho Dai Soke $600 must be a minimum of Godan and posess at leat two (2) other Black Belt ranks, provide written description and requirements for system, video demonstration of all required techniques)(includes Certificate, ID Card and Embroidered Belt)


___Examiner's License $50 Annual Fee (Sandan or higher/Certified Instructor)


___Judge's License $50 Annual Fee (Must hold Black Belt Ranking)


Please compleate all required information and return with payment to:


BUDOKAIKAN INTERNATIONAL                                                     

c/o Sho Dai Soke D. E. Chase

111 Belmont Avenue


Paterson, New Jersey 07522


Please make all checks and/or Money Orders payable to: D. E. Chase