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2021 LTU TKD Membership Application Form
The information collected will be used solely for administration purposes and as part of the La Trobe University sports club requirements.
For any questions or concerns, please contact ltutkd@gmail.com
I am a *
Select the following that apply: *
Student No. (if applicable):
Course Studying:
First Name: *
Surname: *
Preferred name (if applicable):
Date of Birth: *
MM
/
DD
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YYYY
Gender: *
Street: *
Suburb: *
Postcode: *
Phone (Home):
Phone (Mobile): *
Valid email address: *
Existing medical conditions/injuries (e.g. asthma):
Emergency Contact (Name, Phone, Relationship): *
Previous Martial Arts Experience: *
Martial Art:
Belt Rank (if applicable):
Weight:
Previous Competition Experience: *
The membership I'm applying for: *
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