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AOKA
AOKA Individual Membership Renewal
 Please note: Failure to provide a current AOKA number, or the currently registered AOKA school, will result in the full fee of $25.00 per year or $100.00 for a five (5) year membership being charged.

Name *
E-mail Address *
Date (mm/dd/yyyy) *
Membership Type *
  I am a current AOKA member and am providing my AOKA # below.
AOKA Memb. #
  I belong to a currently registered AOKA school. (this will be verified against our database)
Address *
City *
State / Province *
Zip Code *
Telephone (999) 999-9999 *
Current Rank *
Instructor *
Your Dojo Name *
Method of Payment *
Name on credit card (exactly)
Credit Card Number (no spaces)
Exp. Date (MM/YYYY)

* Fields marked with an asterisk are required fields

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