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Aikido of South Florida
Morihei Ueshiba
osensei
osensei2
Tai no henko
osensei and wife

Uchideshi Application

Aikido of South Florida
Uchideshi Application & Information
Name:
Address:
City:
State:
Zip:
Country:
Name of Dojo:
Instructor:
Rank of Instructor:
Age:
Date of Birth:
Home Phone :
Rank:
Aikido Exp:
Date of Arrival:
Date of Departure:
E-mail Address:
 
Why do you wish to enter the Uchideshi Program?
HOW DID YOU HEAR ABOUT OUR UCHIDESHI PROGRAM?
Aikido Today Magazine
Other:
Aiki News Magazine
Referred by:
Yellow Pages  
WHAT IS YOUR MARTIAL ARTS BACKGROUND?
Aikido
Tae Kwon Do
Karate Do
Kung-fu
Iado
None
Judo
Jujutsu
Hapkido
Other:
Kendo    

HAVE YOU EVER BEEN TREATED FOR OR HAVE
CURENT PROBLEMS WITH AN OF THE FOLLOWING?

Heart Problems Migraines
Drug Addiction Back Problems
HIV Depression
Stress Relief Black-outs
Asthma Abnormal Blood Pressure
Other: