Apply to join the Kobukan in the U.S. Product Name(Required) STUDENT: Choose this to learn only as a student. ($50/yr) JR. INSTRUCTOR: Choose this to instruct, but not as primary Kobukan instructor at your location. ($100/yr) HEAD INSTRUCTOR: Choose this is you will be the primary leadership of a Group or Dojo. ($125/yr) Your Kobukan Instructor's NameIf you do not currently have an instructor, or will have Kancho's live class or Online University as your primary instruction, you can leave this blank. First Last Training LocationIf you are applying as a Student or Junior Instructor, please list the City and State of your Kobukan instructors training location. Otherwise, you can leave this blank.Applicant InformationYour Name(Required) First Last Date of Birth(Required)If you are under 18 years of age, please have a parent or guardian complete this for you. MM slash DD slash YYYY Your Email Address(Required)Please let us know the best email to reach you. Your Phone(Required)Please provide the best phone number to connect with you.Your Address(Required) Street Address City ZIP Code To help us support you, we’d love to learn a bit more about you.What previous and/or current martial arts training you practice? (leave blank or type "na" if none)In your own words, what inspires you to join and what you hope to gain from training with the Kobukan.(Required)In addition to training with my local teacher, I'm also interest in:(check all that apply) Online training through Kobukan University Attending Kancho's live online class Attending international Taikai (events) Regional events & seminars Do you have any physical or other limitations we should be aware of? No - I can fully participate without any limitations. Yes - I have a limitation to be aware of. No worries! We try to make our training accessible to as many as possible. Please share anything we should be aware of.Payment MethodPayPal Checkout MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name
