JUDO Promotion request

  Name

Art

  Comments

Address to send rank certificates

Date of Rank test

Name of Instructor

            Rank

Cost is:  $5.00 per Kyu rank   /   $10.00 per Dan Rank   + $4.00 postage      (Patches  add  $5.00 each)

Club Name

          **You must have a mail program on your computer

Check payable to :  Kathy Brooks   P.O. Box 1056 Alto N.M. 88312

Professional Combined Martial Arts, Inc.

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hombu1@valornet.com