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For the Attention of the Chairman of the Board, NPO Aikido Ryu, Tsuneo Ando
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High Rank Dan Application Form
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〇Details of Applicant*Please include a photo with your application.*
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Dojo NameDate of Application (YY/MM/DD)
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Name of Applicant
Date of Birth
(YY/MM/DD)
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Name in KatakanaPlace of birth
(This will be included on your certificate.)
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Mailing AddressNumber of days training per week____ classesper week
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Contact DetailsTELE-MAIL Date of starting Aikido(YY/MM/DD)
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Current Rank  dan(*Received on YY/MM )Applying for Rank of    dan
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*This date should be the date on which your certificate was issued ie. the date on the back of the certificate.
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DateAikido History
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〇Details of Person Recommending Applicant
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NameRank
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Dojo Name
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Relationship to Applicant
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Reasons for Recommending Applicant
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〇Details of Person Recommending Applicant
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NameRank
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Dojo Name
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Relationship to Applicant
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Reasons for Recommending Applicant
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※Dojo representatives who are applying for higher rank will need the supporting recommendation of two other shihan or two other dojo representatives.
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※All other applicants applying for higher rank need the supporting recommendation of their dojo representative and one other shihan or dojo representative.
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