AWSDA - Association for Women's Self Defense Advancement

Membership Application

Step 1 (3)

Please enter your personal information below

First name , MI, Last name, Suffix	Gender

Email *

Address *

City *

State , Zip	Date of birth ("mm/dd/yyyy")
	/ /
Country *

Day phone	Eve phone

Cell phone	Fax

Additional Phone info

Heard about

Purpose

Expertise

Additional information

Letter of Intent (* if you are a man you need to write a letter for approval)

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AWSDA is an international, not-for-profit, (501-c-3) organization. Phone 1-888-STOP RAPE or 201-794-2153. Fax 201-791-6005.
Email info@awsda.org. International Mailing Address 556 Route 17 North, Suite 7-209, Paramus, NJ 07652
Comments? webmaster@awsda.org