Membership Application Form

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MEMBERSHIP
NEW MEMBERSHIP
RENEWING MEMBERSHIP
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Name* This field is required.
First Name
Last Name
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School Name* This field is required.
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Your Postal Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Australia
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Afghanistan
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Liberia
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Montserrat
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Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
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Niger
Nigeria
Niue
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Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
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Poland
Portugal
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Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
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Saint Lucia
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eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
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Ukraine
United Arab Emirates
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Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Mobile* This field is required.
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E-mail* This field is required.
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Website
example@example.com
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How can we best help you? What services / products / information are you interested in? Giving us more info about your status will help us give you more specific support for your needs For example - Are you a new school or established one, how many students do you have, are you a full-time teacher
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What Licences / Certificates / Checks do you have?:* This field is required.
Working with Children check card
Weapons licence
First Aid Certificate
Police Check
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YOUR QUALIFICATIONS TO TEACHPut as much information as possible - (Black Belt / Years of Exp / Academic Cert - Degrees other courses) as this is also used to see if your qualify for Senior & Master Instructor level / 4 & 5 Star Rating Status. These extra levels are available through the Gold Membership.
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The areas I want help in are:
Insurance best prices / policies
Instructor courses - business / coaching skills
Risk management manuals / waiver forms etc
Marketing my club for more students
Managing my club - software options
Direct Debit Services - Student fee collection
Business Mentoring
Website / Mobile App for my club
Training Curriculum / Gradings
Book at time to chat with an expert
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List other Instructors to be Certified?Each instructor will receive their own PDF certificate (bronze), or printed certificate , card & badge with the if they select the Postal Pack (silver & gold), GOLD comes with the option to include 5 instructors or a Senior / Master Level / 4-5 Star Rating All other memberships add $25 per instructor for each accreditation. (We just require - Grade & Years of Experience)
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MAA MEMBERSHIP* This field is required.# BRONZE = ENTRY LEVEL DIGITAL PACK - # SILVER DIGITAL & PRINT PACK WITH PLASTIC CARD & BADGE - # GOLD = FULL PACK WITH OPTION TO INCLUDE SENIOR / MASTER & INSTRUCTOR STAR RATING F YOU TAKE UP 'GOLD' WITH 5+ INSTRUCTORS THERE IS AN EXTRA COST OF $50 FOR THE STAR RATING AS WELL PLEASE SELECT AT LEAST THE BASE LEVEL MEMBERSHIP (BRONZE, SILVER OR GOLD) FROM THE SELECTIONS BELOW
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ORDER SUMMARY
Total costAUD
BRONZE MEMBERSHIPInstructor Accreditation Business assets / graphics pack, magazine, free advertising web page, discounted service range
$100.00AUDEdit
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SILVER MEMBERSHIP - Best ValueBronze + Membership accreditation print pack Discounted Services Tier 2 Event Discounts Club Tier 2 Listing Priority - Print + digital version Mag
$195.00AUDEdit
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GOLD MEMBERSHIP - Valued at over $2000Silver+ 5x Instructor Accreditation & Senior/Master Discount Club Listings - Priority Consultancy Top Tier Graphics/Video pack
$295.00AUDEdit
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ADDITIONAL INSTRUCTORAdd additional instructors to your Membership
$25.00AUDEdit
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Quantity
Add On: SENIOR & UP TO 4 STAR INSTRUCTOR STATUSEligibility Criteria Must Be Met (Min 10 Years Martial Arts Experience)
$50.00AUDEdit
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Add On: MASTER & UP TO 5 STAR INSTRUCTOR STATUSEligibility Criteria Must Be Met (Min 15 Years Martial Arts Experience)
$50.00AUDEdit
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Total cost $0.00AUD
First Name
Last Name
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Would you like to apply for the latest MAA Industry Club Rating Award (4,5 & 6 Star ratings available)4-6 STAR CLUB RATING IS A SEPARATE APPLICATION BASED UPON YOUR OPERATION & MEMBERSHIP YOU CAN TICK IT HERE AND WE WILL SEND YOU THE FORM
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Membership Options* This field is required.
BRONZE - $100
SILVER - $195
GOLD - $295
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MEMBERSHIP ADD ON PREFERENCE# BRONZE = ENTRY LEVEL DIGITAL PACK # SILVER DIGITAL & PRINT PACK WITH PLASTIC CARD & BADGE # GOLD = FULL PACK WITH OPTION TO INCLUDE SENIOR / MASTER & INSTRUCTOR STAR RATING IF YOU TAKE UP 'GOLD' WITH 5+ INSTRUCTORS THERE IS AN EXTRA COST OF $50 FOR THE STAR RATING AS WELL 4-6 STAR CLUB RATING IS A SEPARATE APPLICATION BASED UPON YOUR OPERATION & MEMBERSHIP YOU CAN TICK IT HERE AND WE WILL SEND YOU THE FORM
SENIOR INSTRUCTOR STATUS
MASTER INSTRUCTOR LEVEL
4-5 STAR INSTRUCTOR RATING
4-6 STAR CLUB RATING STATUS
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Credit Card Details
Name on card
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Visa
MasterCard
Card Type
Credit Card Number
Expiry Date
CSV
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