ASSOCIATION MEMBERSHIP APPLICATIONS Step 1 of 2 50% MUST BECOME A MEMBER OF FIMA PRIOR TO JOINING ANY OTHER FIMA ORGANIZATIONS. ALREADY A FIMA MEMBER, THEN PROCEED. IF NOT YET A FIMA MEMBER SELECT FIMA MEMBERSHIP APPLICATION TO APPLY FOR BOTH. ORGANIZATIONS*ICTAIMCOIWASLETAIGDAIMAFIRST* LAST* FIMA ID #* ISRAELI MARTIAL ARTS BACKGROUNDISRAELI MARTIAL ART/STYLE*NONEKRAV MAGAKAPAPHISARDUTKAVANAHHAGGANAHKALAHOTHERRANK* IF BLACK BELT UPLOAD YOUR CERTIFICATEMax. file size: 80 MB.YOUR INSTRUCTOR NAME #1* YOUR INSTRUCTOR NAME #2 SCHOOL NAME* SCHOOL ADDRESS* CERTIFIED AS AN INSTRUCTOR?* Yes No IF INSTRUCTOR PLEASE UPLOAD YOUR CERTIFICATEMax. file size: 80 MB.YOUR INSTRUCTOR NAME #1* YOUR INSTRUCTOR NAME #2 SCHOOL NAME SCHOOL ADDRESS ISRAELI MARTIAL ART/STYLE2NONEKRAV MAGAKAPAPHISARDUTKAVANAHHAGGANAHKALAHOTHERRANK IF BLACK BELT UPLOAD YOUR CERTIFICATEMax. file size: 80 MB.YOUR INSTRUCTOR NAME #1 YOUR INSTRUCTOR NAME #2 SCHOOL NAME SCHOOL ADDRESS CERTIFIED AS AN INSTRUCTOR? Yes No IF INSTRUCTOR PLEASE UPLOAD YOUR CERTIFICATEMax. file size: 80 MB.YOUR INSTRUCTOR NAME #1 YOUR INSTRUCTOR NAME #2 SCHOOL NAME SCHOOL ADDRESS ISRAELI MARTIAL ART/STYLE3NONEKRAV MAGAKAPAPHISARDUTKAVANAHHAGGANAHKALAHOTHERRANK IF BLACK BELT UPLOAD YOUR CERTIFICATEMax. file size: 80 MB.YOUR INSTRUCTOR NAME #1 YOUR INSTRUCTOR NAME #2 SCHOOL NAME SCHOOL ADDRESS CERTIFIED AS AN INSTRUCTOR? Yes No IF INSTRUCTOR PLEASE UPLOAD YOUR CERTIFICATEMax. file size: 80 MB.YOUR INSTRUCTOR NAME #1* YOUR INSTRUCTOR NAME #2 SCHOOL NAME SCHOOL ADDRESS ALL MEMBERSHIPS INCLUDE ASSOCIATION TSHIRT, PATCH, ID CARD AND CERTIFICATE. When you check out you can select 3 year (includes a 5% discount in our online product store), or Lifetime which includes a 10% discount. If you are applying for Instructor certification as well, you will be given this option during check out. NOTICE: All instructor applications require the Instructor certificate to be uploaded. If you have not uploaded, please do so before submitting. These licenses will expire after one year. Renewals will be issued upon submission of instructor approval form. ANNUAL RENEWAL IS $75.*DISCLAIMER AND SIGNATUREPlease accept my application for Membership/ Instructor in the Federation of Israeli Martial Arts. I certify that my answers are true and complete to the best of my knowledge. I understand that false or misleading information in my application may result in discontinuation of membership. * Consent – I have read and agree with the disclaimer(s). Date* MM slash DD slash YYYY
