International TaeKwon-Do Association

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

School Membership Application

(Please Print Or Type)

Name Of School:_____________________________________________________________

Address(Street):______________________________________ City:___________________

State:____________ Zip Code:___________________ Country:_______________________

Date School Opened:_______________________ Phone: (_______)____________________

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

Address To Which All Correspondence Is To Be Sent

Name:(Last)__________________________ First:____________________ M Initial:______

Address(Street):____________________________________ City:_____________________

State:____________ Zip Code:__________________ Country:________________________

Home Phone: (_______)_________________ Work Phone: (_______)__________________

Your Rank:_________________ Number Of Instructors At This School:_________________

Submit a list of the names and addresses of all Instructors and Officials of this school. New School affiliations submit, with this application, the First-Year School Membership Fee, plus another School Membership Application and $50.00 for each additional school you have. All schools must register with the ITA.

I, the undersigned, do hereby agree to register all Instructors, Students (minimum of 5 students), and Schools with the ITA, at this time. I understand that my School(s) are subject to inspection by the ITA President and/or other ITA officials at any time. I agree to adhere to all rules, regulations, policies, and procedures as set forth in the ITA Constitution and By-Laws, and by the President and Board of Directors. I understand that all fees, dues, or payments of any kind are non-refundable.

        ________________________________________     ____________________________
                                           Applicant's Signature                                                                   Date

First Year School Membership Fee: $75.00
(Annual School Membership Renewal Fee: $35.00)

Submit: This Application And Fee, A Photo-Copy Of Your Certificate Of Rank,
Head Instructor Application And Fee,
Individual Applications For Membership, For You and ALL Of Your Students
And The Fees As Indicated On The Applications.

(Make All Fees Payable To ITA, In U.S. Currency Only)

ITA Membership Information