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BUDOKAIKAN INTERNATIONAL
MEMBERSHIP APPLICATION

RANK RECOGNITION/MEMBERSHIP APPLICATION


Full Name


Date of Birth   Sex:

Height   Weight

E-mail address?

Street Address

City

State

Zip Code

Phone Number


Dojo

Street Address

City

State

Zip Code


Sensei


Sensei's Dan Rank


System


Your Current Ranking


Your Rank Date


Please provide photo copies of all Kyu/Dan grades you wish to have certified.

Please give us your Martial Arts Rank History:


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)


Total Cost:

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