Application form Please fill in the blank spaces below. (※) Blank spaces marked with an asterisk (※) are required to be filled. ※Choose the training cente None Ichigaya Training Center Aoyama Training Center Osaka Training Center Osaka NAS Studio Nagoya Studio ※Name Family Name First Name ※Sex Male Female ※Date of birth 191619171918191919201921192219231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020Year 123456789101112Month 12345678910111213141516171819202122232425262728293031Day Student None University/Grad school/Vocational college High school Junior high school primary school Other ※E-mail address Confirm ※Zip code 〒 ※ Prefectures in Japan None Hokkaido Aomori Iwate Miyagi Akita Yamagata Fukushima Ibaraki Tochigi Gunma Saitama Chiba Tokyo Chubu Niigata Toyama Ishikawa Fukui Yamanashi Nagano Gifu Shizuoka Aichi Mie Shiga Kyoto Osaka Hyogo Nara Wakayama Tottori Shimane Okayama Hiroshima Yamaguchi Shikoku Tokushima Kagawa Ehime Kochi Fukuoka Saga Nagasaki Kumamoto Oita Miyazaki Kagoshima Okinawa Overseas ※Address in Japan ※Telephone number How to know Krav Maga None Magazine HomePage TV Program Friend Other Application information ※Payment None Monthly 6 monthes (10% discount) One year (15% discount) ※Courses None Light Regular Premium Day Time Once a week(osaka) Twice a week(osaka) Premium(osaka) Km-X Youth ※Starting day 20212022Year 123456789101112Month 12345678910111213141516171819202122232425262728293031Day If you have special notice or any question, please let us know If you have a friend to start the training together, You will get the 50% off to application fee. If you work at Low Enforcement office, you will get the discount. (Police department, Japanese self defense forces and Military)