ITA Black Belt Membership Application On-Line Registration Form International TaeKwon-Do Association P.O. Box 281 Grand Blanc, MI 48480 USA
When we receive a copy of your current certificate of rank, we shall review it. Once approved, we will then charge your credit card and process your application. Please allow 4 to 6 weeks for processing. (Payments are to be in U.S. Currency)
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Select Membership You Are Applying For: ITA Tae Kwon Do Black Belt Membership (Living Within U.S.)...........$ 95.00 ITA Tae Kwon Do Black Belt Membership (Living Outside U.S.).......$115.00 Membership Application Information First Name: Middle Initial: Last Name: Street Address: City: State: Zip Code: Country: Phone: (Required) What is your e-mail Address?: Date of Birth (Month): JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC Date of Birth (Day): 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Date of Birth (Year): Are You Teaching Tae Kwon Do?: Yes No How Many Years Studying Tae Kwon Do?: What is your current rank?: Date of Rank (Month): JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC Date of Rank (Day): 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Date of Rank (Year): Attach Your Certificate .jpg File:(Required): Attach I.D. Photo Use Your Name with .jpg Extension File:(Required): Top of Page Return To ITA Main Page