intbudoryuacademy.weebly.com€¦ · Web viewMain Office: 36, Via Filippo Bottazzi - 80126 - Naples...
2
INTERNATIONAL BUDO RYU ACADEMY - APPLICATION FORM - Instructions: Type data > Print > Undersign > Scan > Send to [email protected] APPLICANT’S INFORMATION SURNAME MIDDLE NAME, FIRST NAME BIRTH PLACE BIRTH DATE COUNTRY CITY ADDRESS LANDLINE PHONE MOBILE PHONE E-MAIL ADDRESS CURRENT LEVEL MARTIAL ART STYLE/METHOD C DECLARATION The undersigned: applies to be admitted at the International BudoRyu Academy (henceforth “IBA”) acceding its established regulations; expressly relieves IBA from any responsibility in case of injuries or losses occurred before of after events organized within the Academy itself; acknowledges that personal data processing is for the sole pursuit of IBA statutory aims and institutional purposes; acknowledges that data are collected and preserved from IBA Main Office. DOCUMENTS TO BE ATTACHED HEREBY ID Document; Diploma certifying current degree and technical qualification; INTERNATIONAL BUDO RYU ACADEMY Main Office: 36, Via Filippo Bottazzi - 80126 - Naples (ITALY) www.internationalbudoryuacademy.com [email protected] IBAN (bank account transfer no.): IT95A0760103400001040484030 (beware international transfers procedures)
Transcript of intbudoryuacademy.weebly.com€¦ · Web viewMain Office: 36, Via Filippo Bottazzi - 80126 - Naples...
INTERNATIONAL BUDO RYU ACADEMY
- APPLICATION FORM -
Instructions: Type data > Print > Undersign > Scan > Send to [email protected]
APPLICANT’S INFORMATION
SURNAME MIDDLE NAME, FIRST NAME BIRTH PLACE BIRTH DATE
COUNTRY CITY ADDRESS
LANDLINE PHONE MOBILE PHONE E-MAIL ADDRESS
CURRENT LEVEL MARTIAL ART STYLE/METHOD
C
DECLARATION
The undersigned: applies to be admitted at the International BudoRyu Academy (henceforth “IBA”) acceding its established regulations; expressly relieves IBA from any responsibility in case of injuries or losses occurred before of after events organized within the Academy itself; acknowledges that personal data processing is for the sole pursuit of IBA statutory aims and institutional purposes; acknowledges that data are collected and preserved from IBA Main Office.
DOCUMENTS TO BE ATTACHED HEREBY ID Document; Diploma certifying current degree and technical qualification; Self-certification of integrity, stating the absence of criminal records, criminal charges or criminal trials.
By undersigning this form, the applicant takes responsibility for the righteousness of the information provided above.
________________ ______________________________________APPLICATION DATE APPLICANT’S HANDMADE SIGNATURE
INTERNATIONAL BUDO RYU ACADEMYMain Office: 36, Via Filippo Bottazzi - 80126 - Naples (ITALY)
www.internationalbudoryuacademy.cominternationalbudoryuacademy@gmail.com
IBAN (bank account transfer no.): IT95A0760103400001040484030(beware international transfers procedures)
