Isshin-Ryu World Karate Association Membership Application

Name

_________________________________________________________________________________________

Address

__________________________________________________________________________________________

Western Union Number

__________________________________________________________________________________________

Print , Fill out , Send to:

O'Sensei Kichiro Shimabuku

3-1-21 Midorimachi

Uruma City, Okinawa, Japan

904-2215

Allow 6-12 weeks for delivery.

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