AWSDA Membership Application

Online registration is coming soon! In the meantime, however, please print this page, fill in all blanks that apply, and mail it to the address you'll find below. Thanks!

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           American Women's Self Defense Association Membership Application

                               Please mail to:

                                    AWSDA
                              713 N. Wellwood Ave.
                             Lindenhurst, NY 11757




Last Name:                         First Name:                Middle Initial:

Email address:

Web site (if applicable):

Company Name:

Mailing Address:
              


City:                               State:        Zip Code:

Day Phone:

Evening Phone:

Fax Number:


Occupation:

Age:     Sex:



My reason for wanting to join AWSDA is:





Expertise, Experience, or related training:




Additional Comments:




I heard about AWSDA through:





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Male Applicants are required to submit a brief resume plus a letter of intent expaining reasons for applying for AWSDA membership. Please allow 4-6 weeks for processing of application. All applicants will be notified by mail.

AWSDA
713 N. Wellwood Ave.
Lindenhurst, NY 11757

Dues (per year): $35