UK Licence application

WUMA LICENCE & FULL MEMBERSHIP APPLICATION UK ______________________________________________________ _______________________________________________
WUMA members are those that hold current Licences. Please complete ALL BOXES in FULL
Use the TAB button to proceed to the next box, or click directly into the box with your mouse icon.

Full Name	Date of birth Occupation
Address
Telephone	Mobile Email
Club Name	Instructors Name
present grade	style last grading date
Tick Licence applying for	Student Licence @ £20 Blackbelt Licence @ £25 Instructor Licence @ £18
Tick Box	Student Member Certificate @ £5 Blackbelt Member Certificate @ £10 Instructor Member Certificate @ £10
Tick box	Have you applied for a WUMA Licence before: yes no If yes give old Licence number
Comments
	We accept all major Credit Cards and Debit Cards (Switch etc). Fill in the form below and press the Submit button - this will email all your details direct to us
Cost: As above plus a £5 online charge for administration-postage-card bank percentage Attention: Without full payment we cannot forward your application
Card Type
Card Number	Security code (last 3 digits on signature strip on back of card)
Expiry Date	Your post code for added card security:
Issue Number
Cardholder Name
Please double check that all the details are included and are correct. Click the Submit button below ONCE. As soon as we receive this information the Licence will be processed within one week. Many Thanks!

WUMA World Governing Body Headquarters, Cheltenham College of Martial Arts, 130 Barton Street, Gloucester, Gloucestershire, GL1 4EN, , England, UK
Tel/Fax: 01242 261262 Legal Agreements