Dojo Application

To apply for a membership for your Dojo, please provide the information requested at the bottom of this page, and then download and complete the AJA Dojo Application. There is some duplication with some information on the form that you will have already entered and submitted below, but the electronic form helps get things started.

Download our General Waiver form: Genl CA Release 021815

…and our Insurance Details: 2015-InsuranceDetails_UHA6172A_010115b

Send the application package with all required materials to:

Jeff Wynn
AJA Vice President and NSCB Chair
3087 NW Gravenstein St.
Camas, WA 98607
(nscb@aja-email.org)

Evaluation Process

If your application is complete and there are no problems that cause delays, you should receive notification from the AJA within 30-45 days after receipt of your application. If you are approved you will receive an AJA Certificate of Rank, an AJA Instructor Certificate, and your annual AJA Dojo Membership Certificate. For an accurate “received” date mail your application by USPS certified mail with a return receipt or by Priority Mail.

Important

To avoid confusion and delays, be aware that once this application is submitted, AJA rules do not allow you to seek or accept any promotion of rank in ju-jitsu until such time as the BOD accepts your dojo for membership and all appropriate certificates are issued.

Sensei Information

First Name *

Last Name *

Nickname

Rank *

Promotion Date *

Office Position

Home Phone #

Work Phone #

Other Contact

Email Address

Dojo Information

Dojo Name *

Dojo Ryu *

Dojo Building Name

Dojo Physical Address *

Dojo Physical City *

Dojo Physical State *

Dojo Physical Zip *

Dojo Physical Country *

Dojo Phone *

Dojo Class Schedule *

Dojo Mailing Address *

Dojo Mailing City *

Dojo Mailing State *

Dojo Mailing Zip *

Dojo Mailing Country *

Dojo Website

Landlord Information

* If you do not own the building you teach in, this information is required.

Landlord Name

Landlord Address

Landlord City

Landlord State

Landlord Zip

Landlord Phone

I, [your name] * agree that if I am accepted for membership in the AJA that I will abide by the Constitution and Bylaws of the AJA to the best of my ability. I also agree that all participants in my dojo will become paid members of the AJA, at a fee of $20 each per calendar year. I also understand that violation of the Constitution & Bylaws could result in suspension and/or revocation of all AJA certifications and benefits. Furthermore, I grant the AJA permission to use my name, rank, dojo name, dojo location and class schedule on its website and other publications.

Your signature *

Date *

Captcha *