APPLICATION
FOR MEMBERSHIP
SHOTOKAN KODANSHAKAI
INTERNATIONAL
Date:
Applicant’s
Name:
THE
UNDERSIGNED, hereby
submits this application for membership for approval by the Board of Directors
for the Shotokan Kodanshakai International (“SKI”). The undersigned declares,
that the statements made, and the documents submitted along with this
application for membership, are true and correct to the best of applicant’s
knowledge and belief:
Name:
First/Middle/Last:
Date
of Birth: Citizenship:
Mailing
address:
Telephone
No: ( ) Cell: (
)
Fax:
( ) email:
Employer:
Job
Description:
Name
of Dojo:
Address
of Dojo:
Dojo
telephone: ( ) Fax:
( )
Website Address:
Organizational Affiliation (if any):
1)
2)
3)
Your
dates of training in SHOTOKAN KARATE:
1)
Name
of Instructor:
Start:
End:
Name
of Organization:
Address:
Rank
attained: Date
received:
Reason for quit / termination:
2) Name of Instructor:
Start:
End:
Name
of Organization:
Address:
Rank
attained: Date
received:
Reason for quit / termination:
3) Name of Instructor:
Start:
End:
Name
of Organization:
Address:
Rank
attained: Date
received:
Reason for quit / termination:
4) Name of Instructor:
Start:
End:
Name
of Organization:
Address:
Rank
attained: Date
received:
Reason for quit / termination:
5) Name of Instructor:
Start:
End:
Name
of Organization:
Address:
Rank
attained: Date
received:
Reason for quit / termination:
6) Name of Instructor:
Start:
End:
Name
of Organization:
Address:
Rank
attained: Date
received:
Reason for quit / termination:
Total
years of training in SHOTOKAN KARATE:
years
OTHER
MARTIAL ARTS TRAINING/EXPERIENCE:
Please list all Other Martial Arts (e.g. Judo, Jujitsu, Aikido, Tae Kwon Do, Kajukempo, Kung Fu, etc.) training you have received:
1) Name of Instructor:
Martial
Art Style:
Start:
End:
Address:
Rank
attained: Date
received:
Reason
for quit / termination:
2) Name of Instructor:
Martial
Art Style:
Start:
End:
Address:
Rank
attained: Date
received:
Reason
for quit / termination:
3) Name of Instructor:
Martial
Art Style:
Start:
End:
Address:
Rank
attained: Date
received:
Reason
for quit / termination:
4) Name of Instructor:
Martial
Art Style:
Start:
End:
Address:
Rank
attained: Date
received:
Reason
for quit / termination:
5) Name of Instructor:
Martial
Art Style:
Start:
End:
Address:
Rank
attained: Date
received:
Reason
for quit / termination:
6) Name of Instructor:
Martial
Art Style:
Start:
End:
Address:
Rank
attained: Date
received:
Reason for quit / termination:
AWARDS/RECOGNITION
Please describe/list any awards or recognition you have received in SHOTOKAN KARATE. Give the name of the person/organization presenting the award/recognition to you, the date of the award/recognition, and a brief description of the award/recognition:
1) Award: Date:
Presenter:
2) Award: Date:
Presenter:
3) Award: Date:
Presenter:
4) Award: Date:
Presenter:
5) Award: Date:
Presenter:
As a condition to membership into the Shotokan
Kodanshakai International, you must provide a copy of your Dan
Certificate of Rank verifying your highest, and most current dan ranking. All
documents submitted will NOT be returned to you. The submitted documents will
be kept in your permanent file.
If you are unable to provide proof of your dan rank,
you may send in 1) your declaration attesting to your Shotokan Karate training,
and 2) a declaration from another Shotokan Karate instructor in your city,
state/province, based upon his/her personal knowledge, who will attest to your
qualifications and years of training or teaching experience in Shotokan Karate.
Please submit a passport-size, color photograph of yourself. The Photograph shall be a recent photograph of yourself. The photograph must be taken within two (2) months of your membership application submittal to the Shotokan Kodanshakai International (SKI). You must be wearing your gi and the photo must be taken from the chest up. The photograph will be posted on the Shotokan Kodanshakai International website and any official publications authorized by the Board of Directors of SKI . The photograph will NOT be returned to you. The photograph submitted will be kept in our permanent files. The photographs should be emailed: to marne@kodanshakai.com
MEMBERSHIP
For U.S.A., Western European (European Union) applicants, Canadian and Australian applicants, the annual membership fee is fifty dollars (U.S.$50). You may send in your membership deposit by cashier’s check, money order, or PayPal via the internet. The SKI PayPal account can be accessed through the link on the SKI website. Upon your acceptance for membership, your U.S. $50 will then be applied to your annual membership fees. Should you, for whatever reason, be rejected for membership, your deposit will be mailed back to you.
Mail your cashier’s check or money order to:
SHOTOKAN KODANSHAKAI INTERNATIONAL
C/o Sensei Eric Y. Marn
2480 Pali Highway
Honolulu, Hawaii 96817
Tel: 1 (808) 371-7670
Fax: 1 (808) 595-7353
Applicants from countries other than U.S.A., Western Europe (EU), Canada and Australia, please submit your annual membership fee deposit in U.S. dollars, a sum which is one-fifth of one percent (0.2%) of the average per capita income of your country as a deposit toward your annual membership fee. To determine the per capita income of your country, log on to: http://siakhenn.tripod.com/capita.html.
Upon your acceptance for membership into SKI, your deposit will be applied to your annual membership fees. Should you, for whatever reason, be rejected for membership, your deposit will be mailed back to you. Applicants from other countries shall submit a copy of the latest per capita average income for the country wherein he/she resides along with his/her deposit. SKI will endeavor to respond to your membership application within ten (10) working days.
Only a person who has attained the requisite number of years of training to qualify for dan ranking or has a dan ranking may be accepted for membership (see By-Laws of SKI, Article XI, Section 5). Each member shall be entitled to one (1) vote. He/she shall be entitled to vote for directors to the Board of Directors each year.
WEBSITE LISTING
Upon acceptance as a member of the Shotokan Kodanshakai International, and your payment of the annual membership fee, your name, rank, photograph, years of training, city, state/province and country will be posted on the Shotokan Kodanshakai International website.
Should you wish to have additional information posted on the Shotokan Kodanshakai International’s website, such as dojo name, address, telephone no., email address, etc. an additional annual fee shall be required, payable in advance. The annual fee shall be equal to three-tenths of one percent (0.3%) of the average per capita income of your country will be charged. SKI reserves the right to decline or modify the member’s advertisement.
Seminars or Karate camps may be advertised on the SKI website for a one time fee of U.S. $25.
AUTHORIZATION TO CONDUCT BACKGROUND CHECK
In order to ensure that members of SKI are of good moral character, honesty and integrity, the undersigned hereby consents and does hereby authorize SKI, at its discretion, to conduct a background check into the undersigned’s employment, criminal, psychological and credit history, including speaking with his personal references and employers.
WHEREFORE, the undersigned, in consideration of the foregoing, respectfully submits this application for membership into the Shotokan Kodanshakai International (SKI). The undersigned has reviewed the By-Laws of SKI and agrees to abide by the rules and regulations established therein.
Respectfully submitted,
Applicant’s signature