MEMBERSHIP OPTIONS – KENPO INTERNATIONAL

Select One

14 Years Old & Up – $79.00 (One Time)

INDIVIDUAL MEMBERSHIP SELECTION:*
Select One
- INDIVIDUAL CERTIFIED
- INDIVIDUAL ALLIED
- OWNER / INSTRUCTOR CERTIFIED
YOUR INFORMATION
Name*
First Middle Last
Birthday*
MM slash DD slash YYYY
Your Rank*
Style*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
SCHOOL INFORMATION
If Applicable
Name of School/Club
Style
School/Club Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Website
PAYMENT
Checkout via PayPal Account or Debit / Credit Card.
MEMBERSHIP FEE*
Price:
K.I. LARGE CREST
Price: $15.00
K.I. SMALL CREST
Price: $10.00
Additional Members Patch
Price: $5.00
American Kenpo Rocker
Price: $5.00
Amount Due:
$0.00
***Shipping will be calculated at checkout via PayPal or Guest Checkout. Local Pick Up also available.

13 Years Old & Under – $59.00 (One Time)

Children's Membership Selection*
Select One
- INDIVIDUAL CERTIFIED
- INDIVIDUAL ALLIED
Child's Information
Name*
First Middle Last
Birthday*
MM slash DD slash YYYY
Your Rank*
Style*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
SCHOOL INFORMATION
Name of School/Club
Instructor's Name
Instructor's Rank & Style
School/Club Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Website
PAYMENT
Checkout via PayPal Account or Debit / Credit Card.
MEMBERSHIP FEE*
Price:
K.I. LARGE CREST
Price: $10.00
K.I. SMALL CREST
Price: $8.00
K.I. MEMBERS OVAL
Price: $5.00
K.I. ROCKER
Price: $5.00
Amount Due:
$0.00
***Shipping will be calculated at checkout via PayPal or Guest Checkout. Local Pick Up also available.

$199.00 – (One Time)

INDIVIDUAL MEMBERSHIP SELECTION:*
Select One
- SCHOOL / CLUB CERTIFIED
- SCHOOL / CLUB ALLIED
YOUR INFORMATION
Name
First Middle Last
RANK*
SCHOOL / CLUB INFORMATION
Name of School/Club
School/Club Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Website
PAYMENT
Checkout via PayPal Account or Debit / Credit Card.
SCHOOL / CLUB MEMBERSHIP FEE*
Price:
K.I. LARGE CREST
Price: $10.00
K.I. SMALL CREST
Price: $8.00
Additional Members Patch
Price: $5.00
American Kenpo Rocker
Price: $5.00
Amount Due:
$0.00
***Shipping will be calculated at checkout via PayPal or Guest Checkout. Local Pick Up also available.