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If you prefer to mail it to us please print and fill out the following Membership Application Make Check or Money Order to David Seiwert Name:___________________________________________________________ Address:_________________________________________________________ City: ________________________________ State: ______ Zip: ____________ Occupation:______________________________________________________ Email address:____________________________________________________ Art/Style: __________________________________ Rank: ____________________ City: ___________________________ State: ________ Other Training:____________________________________________________ Memberships/Affiliations:___________________________________________ Please accept my application for individual membership in the Dynamic Fighting Arts Organization. I have enclosed my membership dues. Applicant Signature___________________________________Date_________________
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