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National Sport Judo |
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Life Membership Application |
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| Name: | __________________________________________________ |
| Street Address: | __________________________________________________ |
| __________________________________________________ | |
| City, State Zip: | __________________________________________________ |
| Age:____________ | Date of Birth:___/___/___ | U.S. Citizen: Yes No |
| Rank:______________ | Promo. Date:___/___/___ | Years in Judo:________ |
| Phone:_____________ | Fax:_________________ | eMail:_____________________ |
| Judo Club: | _________________________________________________ | |
| Club Address: | _________________________________________________ | |
| Club City, State ZIP: | _________________________________________________ | |
| Coach:____________ | Phone:______________ | eMail:_____________________ |
| 1. | Life Membership is just $50.00. Only active members receive benefits and promotions. All fees must be current to be eligible for promotions or certifications. |
| 2. | National Sport Judo does not discriminate against any other judo group and strongly suggests that its members support other judo groups. National Sport Judo will also do its best to promote harmony with other groups. |
| 3. | The goal of National Sport Judo is to develop judo in the United States by supporting coaches and students with high standards and respect for all. Our goal is not to compete with other associations, only to provide service to our members and the public. |
| 4. | National Sport Judo is a non-profit organization. |
| Life Membership Fee: | $50.00 | ______________ |
| Sponsor Membership: | $200.00 | ______________ |
| Benefactor Membership: | $500.00 | ______________ |
| Trustee Membership: | $1,000.00 | ______________ |
| Send completed application with check payable to: | ||
| National Sport Judo | ||
| PO Box 550464 | ||
| FT. Lauderdale, FL 33355 | ||
| (954) 473-9679 | ||