Athlete Affiliation Form:

First Name:__________________________________________________________

 

Last Name:__________________________________________________________ 

Address:____________________________________________________________ 

City:________________________________________________________________ 

  State:______________________________________________________________ 

  Zip: __________________________

  Country:______________________ 

  Phone Number: (__________)_________________________

  Email:_________________________________________@____________________.__________________ 

  Academy:____________________________________________________________ 

  Black Belt Instructor:___________________________________________________ 

  Instructor signature:____________________________________________________ 

  Instructor  contact phone:_______________________________________________ 

  Date of Birth  Month  Day  Year _________________/_________________/________________________

  

Check or Money Order  Please send payments to:

TNBJJFED

1403 E.Broadway Ave.

Maryville,TN 37804

Send 2 recent 2" X 2 " Passport Photographs

 

Affiliation Fee $15.00

   

New affiliation:

Fill the form and submit

Send 2 recent 2" X 2 "   Passport Photographs

Pay a 15.00 fee

    

Renew:

Fill the form and submit

Send a recent 2" X 2 "  Photograph

Pay a 15.00 renewal fee

    

You will Receive your Federation ID in 7 to 10 business days from the date we receive your request. If you have any questions contact us