~~~~~ KaliJKD-U.com Yearly Membership Order Form ~~~~~
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Name:
*Required 		___________________________________________________

Home/Business Address:

 ___________________________________________________
City: ___________________________________________________
State, Zip Code: ___________________________________,_______________
Country: ___________________________________________________
Email:
*Required 		___________________________________________________
Home/Bus. Phone: __________________________________
~~~~~~~~~~~~~~~Additional Info. ~~~~~~~~~~~~~~~
Martial Arts Studied: ___________________________________________________
___________________________________________________
How did you hear of Kali/JKD-U? _______________________________________________
Check, Money Order, or Cashier's Check can be sent to:
Rudy Rogers/Kali/JKD University On-line
P.O. Box 580542
Minneapolis, MN 55458
Payment Method

Check Money Order Cashier's Check

Amount Enclosed:

 $___________________________
* ($160.00/yr) U.S.
*Allow a 2 week approx. processing time on personal/business. checks. Membership will be activated upon receipt of other forms of payment. Please do not send cash. Your username and password will be emailed to the email you provided above upon activation of your membership. You may renew your membership
at anytime after that. You are able to cancel your membership for 1/2 half of
your original fee within 2 weeks of activation in writing.
Thank You!