SCHOOL AFFILIATION APPLICATION (PLEASE PRINT OR TYPE) NAME OF SCHOOL OR CLUB ______________________________________________________________________________ ADDRESS _________________________________________________________________CITY _________________________ STATE ______________________ ZIP CODE ____________________________ COUNTRY ___________________________ PHONE # (________) __________________________ EMAIL _____________________________________________________ ADDRESS TO WHICH ALL CORRESPONDENCE IS TO BE SENT NAME (LAST) _______________________________________________ FIRST _________________________ INITIAL _____ ADDRESS _________________________________________________________________CITY _________________________ STATE ______________________ ZIP CODE ____________________________ COUNTRY ___________________________ PHONE # (________) __________________________ EMAIL _____________________________________________________ ADDITIONAL PHONE # (_________) _____________________________ PLEASE SUBMIT A LIST OF ALL INSTRUCTORS AND OR OFFICIALS OF THIS SCHOOL ON THE ATTACHED FORM. THE SCHOOL AFFILIATION FEE MUST ACCOMPANY THIS FORM. I, THE UNDERSIGNED DO HEREBY APPLY FOR SCHOOL/CLUB AFFILIATION WITH NORTHERN KNIGHTS MARTIAL ARTS AND AGREE TO REGISTER ALL INSTRUCTORS AND STUDENTS UNDER MY AUTHORITY. I UNDERSTAND THAT MY SCHOOL IS SUBJECT TO INSPECTION BY THE NKMA PRESIDENT AND/OR OTHER NKMA OFFICIALS AT ANY TIME. I ALSO AGREE TO OBSERVE ALL THE POLICIES AND PROCEEDURES AS SET FORTH BY THE NKMA BOARD OF DIRECTORS. I AGREE THAT AT SUCH TIME MY SCHOOL IS NO LONGER AFFILIATED WITH NORTHERN KNIGHTS MARTIAL ARTS ANY INFORMATION, POLICIES, PROCEDURES OR REQUIREMENTS DIRECTLY RELATED TO THE NKMA ORGANIZATION SHALL NOT BE COPIED IN ANY MANNER. I UNDERSTAND THAT ALL FEES RELATED TO NKMA AFFILIATION ARE NOT REFUNDABLE. _______________________________________________________                                  __________________________________ APPLICANT’S SIGNATURE                                                                                                        DATE APPROVED BY _________________________________________________              _________________________________________________     NKMA – PRESIDENT                                                                                                     NKMA-VICE PRESIDENT