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INSTRUCTOR LICENSE APPLICATION
To be completed by recommending instructor. All fields must be completed.		Photo

(Required)
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 Ryu World Aikido Federation
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*Please print neatly
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First nameFamily name
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Name in Japanese characters (if known)
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Home address

Tel		Mailing address (if different from home address)

Tel
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TelTel
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Email addressNationality
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Date of birth (YY/MM/DD)
Sex M / F
M/FDojo
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Do you currently have an instructor's license?(Please circle) Yes/No
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If you do, what kyu/dan can you grade to?Can grade to Kyu/Dan
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 Aikido History
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Dan historyInstructor's license history
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*Level**Date of issue (YY/MM/DD)Examining InstructorRegistered instructor level**Date of issue (YY/MM/DD)Examining instructor
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Started
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1st kyu
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1st danGrade to 4th kyu
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2nd danGrade to 1st kyu
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3rd danGrade to 1st dan
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4th danGrade to 2nd dan
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5th danGrade to 3rd dan
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6th danGrade to 4th dan
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7th danGrade to 5th dan
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8th danGrade to 6th dan
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*The field for applied level should be left blank. **Indicated on the back of the certificate.
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Instructor’s Recommendation
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I,( dan ),recommend the above,
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 , grading responsibility to
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Recommending instructor’s signature Date Dojo
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