This application is for students and Instructors registering in the art of Yoshin Ryu Jujitsu from video training. You will receive a Yoshin Ryu Jujitsu Certificate from this application (with a green yin-yang).

Print this form page, fill it out and send it with your $45 Registration fee to:

Name ____________________________________________________________

(note the standard rank levels on the Yoshin Ryu Jujitsu member page)

Style: Yoshin Ryu Jujitsu

Mailing Address_____________________________________________________

_________________________________________________________________

Email Address______________________________________________________

Date of Birth_______________________________________________________

School Name (optional)______________________________________________

Your web site (optional)______________________________________________