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Dojos/Schools
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DOB
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e-Mail (Your Email Address)
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Phone
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Official JA Rank
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1st Dan (Shodan)
2nd Dan (Nidan)
3rd Dan (Sandan)
4th Dan (Yodan)
5th Dan (Godan)
6th Dan (Rokudan)
7th Dan (SHICHIDAN)
8th Dan (HACHIDAN)
9th Dan (KUDAN)
10th Dan (JUDAN)
Non-Dan; Ikkyu
Non-Dan; Nikyu
Non-Dan; Sankyu
Non-Dan; Below Sankyu
Black Belt
Martial Arts Style(s)
any of selected
all of selected
none of selected
Aikido
American Combat Jujitsu
American Kenpo
American kickboxing
Arnis/Eskrima/Kali
Brazilian Jiu-Jitsu/Gracie Jiu-Jitsu
Capoeira
Castoldi's Self Defense
Danzan-ryū
Filipino Kali
Hakkoryu Jujutsu
Hapkido
Hwa Rang Do
Iaido
Jeet Kune Do
Judo
Jujitsu
Jun Fan
Kajukenbo
Kali
Karate
Ken Jutsu
Kodenkan Jujitsu
Krav Maga
Kuk Sool Won
Majapahit Silat
Mixed Martial Arts
Modern Army Combatives
Muay Thai
Mushin Ryu Jujitsu
OTHER
Pentjak Silat
Quest MA
Quest Martial Science
Sambo
Shen Chun Do
Small Circle Jujutsu
T'ai Chi Ch'uan
Taekwondo
Tang soo do
Vale Tudo
Within Arm’s Reach
Mailing List
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Other Dojo Representatives
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Date Dojo Organized
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Website (Individual or Dojo)
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Number of Students
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Address
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How Did You Hear About Us?
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Internet
Referral
Dojo Instructor
Tournament
Clinic
Other Affiliations
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MARTIAL ARTS EXPERIENCE AND RANKS HELD:
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JA Instructor
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