DAN MEMBER DATA FORM – Shin Kaze Aikido Alliance

Please let us know if you are having anyy issues <shinkazeaikidoalliance@gmail.com>.

Name of person requesting this dan registration (*required)

Email of person requesting this dan registration (*required)

1. Active (*required)

2. Current Rank (*required)

3. Date current rank awarded (*required)

4. Examiner's name and designation for present rank (*required)

5. Place where present rank obtained

6. First Name (*required)

7. Middle Name

8. Last Name (*required)

9. Record ID (*required)

10. Date of Birth (*required)

11. Hombu Registration Number (*required)

12. Registration Date (*required)

13. Aikikai Membership Number (*required)

14. Nationality

15. Email

16. Language (*required)

17. Status (*required)

18. Gender (*required)

19. Dojo Name (Please select the correct dojo name where the member practices) (*required)

20. Dojo ID (Please make sure to select the correct Dojo ID# that matches with the dojo name in the above field) (*required)