Admission Form

PAK KAN

The Best Professional Karate in World

Admission Form

Registration No:                                                                            Dated:                                    

Name:                                                                                    Father Name:                                                         

Date of Birth:                                            Height:                                Weight:                           

Occupation:                                                                 Father’s Occupation:                                                

Future Plans:                                                                                                                                                 

Address:                                                                                                                                                         

NIC No:                                                                                                                                                          

PTCL No:                                                                        Mobile No:                                                                         

I hereby confirm that I have read and understood all the terms and conditions mentioned at the back side of this form and agree to abide to the same sincerely, and shall practice with extreme vigor and whole heartedness.

                                                                                 Signature:                                                                                 

FOR OFFICIAL USE ONLY

	Affx Photo

Package Selected:                                         

                                    Admission Fee:                                              

Monthly Fee:                                                               

Karate Kit Fee:                                              

Ninja Weapon Fee:                                  Total:                                                                         

Membership Status: O   Accepted  O   Rejected   

Reason for Rejection:                                                                                                                                   

                                                                       

Signature of PAKKAN Authorized Official :