Form – Bangladesh Karate Combat Association

BANGLADESH KARATE COMBAT ASSOCIATION

MEMBERSHIP APPLICATION FORM

Email: bkca2015.bd@gmail.com | Contact: 01822597250

Website

1. Personal Information

Full Name (Capital Letters) *

Father's Name *

Mother's Name *

Date of Birth *

Gender *

Male Female Other

Nationality *

NID / Birth Registration No. *

Occupation

Mobile Number *

Passport Size Photo (3.5 x 4.5 cm) *

2. Permanent Address

House No. / Road

Village / Area

Post Office

Upazila

District

3. Present Address (if different)

House No. / Road

Village / Area

Post Office

Upazila

District

4. Karate Information

Current Belt Rank

Previous Karate Experience (if any)

Preferred Training Branch / Dojo

5. Membership Type

Type *

New Membership Renewal Transfer (from other club/association)

Membership Duration

6 Months 1 Year Others

If Others, specify

6. Emergency Contact / Parent Information

Name *

Relationship *

Contact Number *

Address

7. Declaration

I hereby declare that the information provided above is true and correct to the best of my knowledge. I agree to abide by the rules and regulations of Bangladesh Karate Combat Association (BKCA).

I agree *

Applicant's Signature (type your full name) *

Date *

8. Our Courses

Select the course(s) you want to join *

Monthly Fee 800/- | Admission 1000/- Karate Package (all courses together)

Karate for Self Defence
Knife Techniques
Stick Fight Techniques
Sports Karate

Fee: With Discussion Nunchaku Training Unarmed Combat Course Sword Training

9. Payment (Manual)

Please send the fee manually via bKash, Rocket or Nagad, then fill in the details below. (Required for the Karate Package.)

For the payment number, please contact BKCA: 01822597250

Payment Method

bKash Rocket Nagad

Your bKash / Rocket / Nagad Number (sender)

Transaction ID (TrxID)

Amount Paid (BDT)