First_Name:

Last_Name:

Address:  

City:       

State:         Country: Other participating country:

Canada, UK, and Romania.

Zip_Code:   

Home_Phone:

Work_Phone: 

Cell_Phone:   

Beeper:       

Email_Address:

Criminal Record:Yes: No:

Military Service: Yes: No:

Rank:

MOS:

Which_military_service_where_you_in?

Did you see action: Yes: No:

Are you licensed to carry a weapon? Yes: No:

Ht: Wt: Hair_Color:

Black_Belt_Rank: School_Owner: Yes: No:

MA_Styles:

MA_Documentation: (May be submitted electronically) to ront398675@aol.com

What type of work are you doing now?

List 3 references, Name and phone number:

Ref.1_Name:

Ref.1_Phone:

Ref.2_Name:

Ref.2_Phone:

Ref.3_Name:

Ref.3_Phone:

Have you read the requirements page? Yes: No:

 

Age: