International Hapkido Federation (World Headquarters) P.O. Box 281, Grand Blanc, MI 48480, USA Telephone: (810) 232-6482

Name:(Last)__________________________ First:_____________________ M Initial:_____

Address(Street):_____________________________________ City:____________________

State:__________ Zip Code:_____________________ Country:_______________________

Date Of Birth: Month______ Day______ Year________ Phone: (_______)_______________

Instructor's Name:________________________________ Instructor's Rank:______________

Your Present Rank:____________ Date Of Rank: Month______ Day_____ Year:__________

How Many Gups At This School?__________ How Many Dans At This School?___________

I, the undersigned, do hereby apply for Head Instructor status in the IHF (International Hapkido Federation™). I agree to adhere to all the rules and regulations which govern this organization and to follow the policies and procedures set forth in the IHF Constitution and By-Laws and by the Board of Directors and the President.

I am registering my School and all of my students with the IHF and registering all those who teach at my School, as Instructors, with the IHF. I understand that under no circumstances will I be permitted to issue and/or have printed, any type of certificate or card, of rank. I further understand that all IHF Individual Applications for Membership and promotions must be presented to IHF World Headquarters and must be signed by the President and bear the IHF Official Seal.

In consideration thereof, I hereby agree that should I fail to abide by the IHF's policies, procedures, and regulations, I may be dismissed and that I shall not be entitled to a refund of any kind. I understand that all payments of any kind are non-refundable.


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                                           Applicant's Signature                                                                   Date