Name Of The Applicant Mr./ Mrs. *

Date Of Birth *

Gender

Male Female

Age

Name Of The School / College / Company *

Occupation

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Single Married

Blood Group *

Weight :

Address Of Candidate *

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PINcode

PhoneNumber Resident *

PhoneNumber Mobile *

Father Name *

Mother Name * :

Occupation *

Occupation :

Company *

Company * :

Email ID *

Email ID :

I hereby apply for registration as a member of the International seishin ryu Karate Federation India.

Place *

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