LICENCE APPLICATION FORM

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					           SHIRO-NO ZEN JUDOKWAI
                           Founded 1957 by Sensei Christophe Hopkinson:
                               Sensei George Launders 5th Dan BZJFA
                          Senior Instructor Neil Hopkinson 2nd Dan BZJFA
                                Co the Mosses Centre Cecil street Bury




  Mobile: 07967777210 or 0774643 608 Email: judokid88@hotmail.com or shiro-nozenjudokwai@ntlworld.com



                               JUDO KIT ORDER FORM

NAME

TELEPHONE NUMBER
ADDRESS



SIZE/S                                                               NUMBER
                                                                     REQUIRED
MAKE/S
PRICE PER                  £
KIT                        £                     TOTAL                     £
                           £                     PRICE




                  SHIRO-NO ZEN JUDOKWAI
  Chairman & Chief Instructor: Sensei George Launders 5th Dan BZJFA Treasurer/ vice chairman and
          Senior instructor Neil Hopkinson 2nd Dan.C.o. the Mosses Centre Cecil street Bury
  Mobile: 07967777210 or 07746436608 Email: judokid88@hotmail.com or shiro-nozenjudokwai@ntlworld.com


                                            RECIEPT
RECEIVED WITH THANKS IN
RESPECT OF THE ORDER FOR

             THE SUM OF
                                                    £
DATE RECEIVED
        SIGNATURE                                                         PRINT

				
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posted:9/29/2012
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