International Isshinryu Karate Association

I.I.K.A. Membership Request Form

If you would like to become a member of the International Isshin-ryu Karate Association, please fill out the required information below.

After your information is reviewed and confirmed, a member of the I.I.K.A. staff will ask that you submit the following items.

1. A recent photo of yourself

2. Two copies of your rank certificates

3. Membership fee

I.I.K.A. Membership Request
- Yes
Membership Type
First Name
Last Name
Home Street Address
City
State
Postal Code
Phone Number
Email Address
Current Rank
Gender
- Male
- Female
Age
Name Of Dojo Affiliation
Dojo Street Address
City
State
Postal Code
Name Of Chief Instructor
Rank Of Chief Instructor
Please List Three Of Your Latest Promotions
- OK
- NA
Rank 1
Date Of Promotion
Awarded To You By (Sensei)
Rank 2
Date Of Promotion
Awarded To You By (Sensei)
Rank 3
Date Of Promotion
Awarded To You By (Sensei)
Information Acknowledgement. I certify to the best of my knowledge that the information provided in this application is true and that I will uphold the rules, regulations and by-laws of the International Isshin-ryu Karate Association at all times.
- I Certify
Please Write Your Name To Certify
Send Request

Thank you for your Membership Request. After the verification process is finalized,a Member of the I.I.K.A. Staff will be in contact with you to confirm your information. Please allow 2-3 weeks to complete this procedure.

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International Isshin-ryu Karate Association

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I.I.K.A. Membership Request Form