For Aikikai Use
Certificate No.

AIKIKAI FOUNDATION

Grade Given
DanKyuRank Applied for

AIKIDO WORLD HEADQUARTERS

17-18 Wakamatsu-cho Shinjuku-ku, Tokyo 162-0056 JAPANDanAPPLICATION FORM FOR

Attendance after
Present Rank
obtainedKyu

Days

DAN/KYU GRADING EXAMINATIONS
Aikikai Membership
Please Print or Type No.:First Name*
Family Name*

Nationality:

Date of Aikikai

Registration:
Date of Birth;

Sex:
MaleFemale

English Alphabet

Address:(country)

Name of Dojo:Name of Org. or Group:

Present Rank Information (Rank, Place Obtained, Date)
Rank:
Place:
Dan/KyuRemarks:

Date of Examination

Date:

Examiner's Name:(signature)(print)Examination Fee

I hereby make my application.

Registration Fee

Signature:

Date:

INSTRUCTIONS:
2. Please send your Yudansha Book when you apply.
1. Applicants fill in the boxes enclosed by a heavy line.
3. Examiners fill in boxes enclosed by a double line. Do not forget your 'Signature'. The single line boxes are for Aikikai use.
4. Examination fees and registration fees are not refundable for any reason. 5.Do not change the size or shape of this form.
The Aikikai treats all information with the greatest care and in accordance with the laws on protection of personal information.

*Write your name in CAPITAL LETTERS as you want it to appear on your diploma. Please add 'English' alphabet under your name.

FORM-1140903

For Aikikai Use
Certificate No.
Grade Given

AIKIKAI FOUNDATIONDan

AIKIDO WORLD HEADQUARTERS

Kyu

17-18 Wakamatsu-cho Shinjuku-ku, Tokyo 162-0056 JAPANRank Applied forDan

Attendance after
Present Rank
obtainedKyu

APPLICATION FORM FORDays

DAN/KYU GRADING EXAMINATIONS
Aikikai Membership

Nationality:

Date of AikikaiRegistration:

Please Print or Type No.:First Name*

Family Name*

Date of Birth;

Sex:
MaleFemale

English Alphabet

Address:(country)

Name of Dojo:Name of Org. or Group:

Present Rank Information (Rank, Place Obtained, Date)
Rank:
Place:Dan/
Kyu

Remarks:

Date of Examination

Examiner's Name:(print)(signature)
Examination Fee

I hereby make my application.
Date:

Date:

Signature:

Registration Fee

INSTRUCTIONS: *Write your name in CAPITAL LETTERS as you want it to appear on your diploma. Please add 'English' alphabet under your name.
1. Applicants fill in the boxes enclosed by a heavy line.
2. Please send your Yudansha Book when you apply.
3. Examiners fill in boxes enclosed by a double line. Do not forget your 'Signature'. The single line boxes are for Aikikai use.
FORM-1
4. Examination fees and registration fees are not refundable for any reason. 5.Do not change the size or shape of this form.
140903The Aikikai treats all information with the greatest care and in accordance with the laws on protection of personal information.

AIKIKAI FOUNDATION
会員番号/ID#入会日/DoE

AIKIDO WORLD HEADQUARTERSAPPLICATION FORM FOR
ENROLLMENT IN AIKIKAI
Date:(dd / Mmm. / yyyy)↑Aikikai Use

Please Print or Type

Applicant's (First Name) (Family Name)Name*:English alphabet

Date of Birth:

MaleFemale

Sex:
Nationality:

Address:
Name ofOrganization or Group:
Name of Dojo:Name ofDojo Representative:

Applicant'sSinged Date:(dd / Mmm. / yyyy)*Write your name in CAPITAL LETTERS as you want it to appear on your diploma. Please add 'English' alphabet under yourname, since the Aikikai cannot input other language letters such as Cyrillic letters, Umlaut and Arabic, etc.
-Successful 1st-dan applicants must become a member of the Aikikai Foundation by registering with this form.
-The Aikikai treats all information with the greatest care and in accordance with the laws on protection of personal information.

FORM-2140903AIKIKAI FOUNDATION
会員番号/ID#
入会日/DoE

AIKIDO WORLD HEADQUARTERSAPPLICATION FORM FOR
ENROLLMENT IN AIKIKAI
Date:(dd / Mmm. / yyyy)↑Aikikai Use

Please Print or Type

Applicant's (First Name) (Family Name)Name*:English alphabet

Date of Birth:

Sex:
Nationality:

MaleFemale

Address:
Name ofOrganization or Group:
Name of Dojo:Name ofDojo Representative:

Applicant'sSinged Date:(dd / Mmm. / yyyy)*Write your name in CAPITAL LETTERS as you want it to appear on your diploma. Please add 'English' alphabet under yourname, since the Aikikai cannot input other language letters such as Cyrillic letters, Umlaut and Arabic, etc.
-Successful 1st-dan applicants must become a member of the Aikikai Foundation by registering with this form.
-The Aikikai treats all information with the greatest care and in accordance with the laws on protection of personal information.

FORM-2

140903

For Aikikai Use

For Aikikai Use

AIKIKAI FOUNDATION

証書番号

AIKIDO WORLD HEADQUARTERSAPPLICATION FORM FOR

有段者NO.

会員番号/ID#

入会日/DoE

AIKIKAI INTERNATIONAL YUDANSHA BOOK
Date:
(dd / Mmm. / yyyy)

Please Print or Type

Applicant's (First Name)Name*:(Family Name)

English alphabet

Date of Birth:

MaleFemale

Sex:

Nationality:

Address:
Name ofOrganization or Group:
Name of Dojo:Name ofDojo Representative:*Write your name in CAPITAL LETTERS as you want it to appear on your Yudansha-book.
-Successful 1st-dan applicants must obtain an AIKIKAI INTERNATIONAL YUDANSHA BOOK by registering with this form.
-For reissuance of Yudansha Book, please use this form and provide yourAikikai MembershipNo.

and/or Yudansha issue

No. A

FORM-3-The Aikikai treats all information with the greatest care and in accordance with the laws on protection of personal information.

140903

For Aikikai Use

For Aikikai Use

AIKIKAI FOUNDATION

証書番号

AIKIDO WORLD HEADQUARTERSAPPLICATION FORM FOR

有段者NO.

会員番号/ID#

入会日/DoE

AIKIKAI INTERNATIONAL YUDANSHA BOOK
Date:
(dd / Mmm. / yyyy)

Please Print or Type

Applicant's
Name*:(First Name)(Family Name)

English alphabet

Date of Birth:

Sex:

Nationality:

MaleFemale

Address:
Name ofOrganization or Group:
Name of Dojo:Name ofDojo Representative:

Aikikai MembershipNo.

and/or Yudansha issue

No. A--The Aikikai treats all information with the greatest care and in accordance with the laws on protection of personal information.

FORM-3

For Aikikai Use
Certificate No.
Grade Given
DanKyuAIKIKAI FOUNDATION

Rank Applied for

AIKIDO WORLD HEADQUARTERS

117-18 Wakamatsu-cho Shinjuku-ku, Tokyo 162-0056 JAPANAPPLICATION FORM FOR

Attendance after
Present Rank

DanobtainedKyu

200Days

DAN/KYU GRADING EXAMINATIONS
Aikikai Membership
Please Print or Type No.:First Name*
Family Name*JUAN

Nationality:

Date of Aikikai

ARGENTINA

Registration:

Date of Birth;

PEREZ

10-oct-1970

English Alphabet

Address:
Name of Dojo:(country)

LOCALIDAD DE DONDE ESNOMBRE DEL DOJO

Name of Org. or Group:

Present Rank Information (Rank, Place Obtained, Date)
Rank:
Place:
Date:
Dan/ 1 Kyu
fundacion aikido argentina
Remarks:

Date:

Signature:

MaleFemaleARGENTINA

Date of Examination

fecha examen

juan tolone shihan
I hereby make my application.

xFundacion aikido argentina

Examiner's Name:(print)Sex:(signature)
Examination Fee
Registration Fee

AIKIKAI FOUNDATIONAIKIDO WORLD HEADQUARTERSAPPLICATION FORM FOR
ENROLLMENT IN AIKIKAIMISMA FECHA DE EXAMEN
Date:

会員番号/ID#
入会日/DoE↑Aikikai Use(dd / Mmm. / yyyy)

Please Print or Type

Applicant's (First Name)Name*:(Family Name)JUAN PEREZEnglish alphabet

Date of Birth:

FECHA NAC

ARGENTINA

Nationality:

Sex:

Address:
Name ofOrganization or Group:

FUNDACION AIKIDO ARGENTINANOMBRE DEL DOJO

Name of Dojo:Name of

FUNDACION AIKIDO ARGENTINA

Dojo Representative:

Applicant'sSinged Date:

MaleFemale

For Aikikai Use

For Aikikai Use

AIKIKAI FOUNDATION

証書番号

AIKIDO WORLD HEADQUARTERSAPPLICATION FORM FOR

有段者NO.

会員番号/ID#

入会日/DoE

AIKIKAI INTERNATIONAL YUDANSHA BOOK
Date:
(dd / Mmm. / yyyy)

Please Print or Type

Applicant's (First Name)Name*:(Family Name)JUAN PEREZEnglish alphabet

Date of Birth:

Sex:

Nationality:

ARGENTINA
FECHA DE NACIM
Address: LOCALIDAD DE DONDE ES

Name ofOrganization or Group:

MaleFemale

FUNDACION AIKIDO ARGENTINANOMBRE DEL DOJO

Name of Dojo:Name of

FUNDACION AIKIDO ARGENTINA

Dojo Representative:*Write your name in CAPITAL LETTERS as you want it to appear on your Yudansha-book.
-Successful 1st-dan applicants must obtain an AIKIKAI INTERNATIONAL YUDANSHA BOOK by registering with this form.
-For reissuance of Yudansha Book, please use this form and provide yourAikikai MembershipNo.

and/or Yudansha issue

No. A--The Aikikai treats all information with the greatest care and in accordance with the laws on protection of personal information.

FORM-3