REGISTRATION APPLICATION

Name:

Mailing address:

E-mail:

Your rank that you are registering:

The name of your martial arts style:

The name of the martial arts school you are registering: 

Current member registration number:

Listed on-line. Yes or No

How did you hear about the CMAPA?

Referral Number: (if applicable)

Signature:

Date:

Be sure to only send photo copies of any supporting documentation (DO NOT SEND ORIGINALS)   

Send and make payable to:

Temple Arts

2277 East Elm Street 

 Lima, Ohio 45804