Membership Application

To join print out this form on your printer and mail to:

Combat Dynamics Martial Arts Association
986 Amboy Amboy Avenue
Edison, NJ 08837
  • Please include MONEY ORDER made payable to "Combat Dynamics"
  • Money orders recieved, shipped same day.
  • If paying by personal check, allow 7 days for check to clear before shipment.

You will receive a JKD and White Tiger Kempo Certificate of Membership suitable for framing and display in addition to newsletter subscription.

NOTE: Black Belt Membership is $75.00 all others are $50.00. Send in copies of rank certificates. Black Belts will receive special black belt certifcation.

Please Print:

Name of Applicant ______________________________________
Address ______________________________________
City/State/Zip ______________________________________
Telephone ______________________________________
Date of Birth ______________________________________
Present Rank ______________________________________
Length of time in Martial Arts ______________________________________
Name of Dojo ______________________________________
Telephone (Dojo) ______________________________________
Style/System ______________________________________
Address (Dojo) ______________________________________
City/State/Zip (Dojo) ______________________________________
Instructor's Name ______________________________________
What are your reasons for joining CDIMAA ______________________________________
  ______________________________________
  ______________________________________