AIKIA Application for Black Belt Instructor (Taekwondo/Karate/Tangsoodo/Hapkido/Kickboxing) $199
(Name) (Date of Birth) (e-mail address for receiving newsletter)
(Street address)(Apartment or P. O. Box number)
(City) (State) (Zip code) (Phone number)
In _________ (year) I received the 1st degree black belt from my instructor ___________________________________ (name of instructor) whose school was/is located at _______________________________________________________________________ (address of school). (Include a copy of all black belt certificates. Any misinformation may result in forfeiture of your application fee of $199).
____________ Enclosed is my application fee of $199. I understand I will receive the Aikia Black Belt membership certificate, Aikia Black Belt Instructor certificate, Aikia Instructor patch, and the Aikia business manual download. I receive a free download of the book manuscript Joe Lewis American Karate Systems by Joe Lewis and Dr. Jerry Beasley (first published as The Greatest Karate Fighter of All Time by Paladin Press, 1998) and a free download of the book manuscript for JKD: High-Risk Sparring by Dr. Jerry Beasley featuring Joe Lewis (published by Unique publications, 2008). I receive 10 student memberships that I may resale to my students for a retail value of $200. When I am ready I may test for Black Belt advancement at no charge.
AIKIA STUDENT MEMBER: Not a Black Belt? You can still enjoy the benefits of worldwide rank accreditation for the nationally advertised membership fee of only $20. Send us a copy of your current rank certificate and fee. We will send you the Aikia members only card with your name and official rank noted.
For questions, write: ceo@AIKIA.net
P. O. Box 402
Christiansburg VA 24068