Ki Whang Kim Tradition Martial Arts Association Membership Application
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First Name *
Last Name *
Email *
Street Address *
City *
State *
Zip Code
Phone number *
Birthday
MM
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DD
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YYYY
Gender
Ki Whang Kim Lineage Instructor and rank (if applicable)
Current School/Club *
Current Master Instructor/Rank *
Your Rank/Date Received *
Membership Certification
I hereby certify that I will abide by the rules set forth by the Association and conduct myself in a respectful manner to all member participants. Failure to abide by these terms will result in membership termination.

 I also certify that I am eligible for membership in Ki Whang Kim Traditional Martial Arts Association and will not transfer it to anyone else. This certification concerns a matter within the jurisdiction of the Ki Whang Kim Traditional Martial Arts Association of the United States and making a false, fictitious or fraudulent certification may render the maker subject to criminal prosecution under title 18, United States code section 1001, civil penalty action provided for administrative recoveries of up to $5000 per violation, and/or agency disciplinary actions up to and including dismissal. 
Name/Date (filling in name constitutes signature)
Privacy Act Statement: This information is solicited under authority of Public Law 101-509. Furnishing the information on this form is voluntary, but failure to do so may result in disapproval of your request for membership. The purpose of this information is to facilitate timely processing of your request, to ensure your eligibility, and to prevent misuse of the funds involved.
Submit Payment
Membership in the Ki Whang Kim Traditional Martial Arts Association is $100 a year. Please send a Zelle payment to kwktmaatuition@gmail.com.
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