Please complete the form below: Are you an existing member? NoYes Please enter your membership number below Do you require a new ID Card? YesNo Please enter your first name Please enter your second name Please enter your last name/surname Please enter your birthdate (day/month/year) Date of Birth Please select your race AfricanColouredIndianWhiteOther Please select your gender MaleFemale Please enter your age Please enter your ID number Please enter your height in centimeters Please enter your weight in kilograms Please enter your current belt/rank ---BeltRank ---WhiteRed stripeYellowOrangeGreenBluePurpleRedBrownBlack Please select your current Dan ---1st Dan Black2nd Dan Black3rd Dan Black4th Dan Black5th Dan Black6th Dan Black7th Dan Black8th Dan Black9th Dan Black10th Dan Black ---SenseiShihanRenshiKyoshiHanshiOther If Other, Please Specify Please enter your email Please enter your contact number Please enter your physical address Please enter your guardian information (if applicable) Please enter your Dojo Information Province: ---Western CapeGautengEastern CapeFree StateLimpopoKwazulu NatalNorthern CapeNorth West ProvinceMpumalangaUSSASAPS Region: ---West Coast (Malmesbury)Boland (Stellenbosch)Overberg (Swellendam)Eden (George)Central Karoo (Beaufort West)Cape Town Unicity (Cape Town) ---Sedibeng (Vereeniging)Johannesburg (Johannesburg)Ekurhuleni (Germiston)Metsweding (Bronkhorstspruit)TshwaneWest Rand ---Cacadu (Grahamstown)Amathole (East London)Buffalo City (East London)Chris Hani (Queenstown)Ukhahlamaba (Aliwal North)O R Thambo (Umtata)Nelson Mandela (Port Elizabeth) ---Xhariep (Trompsberg)Motheo (Bloemfontein)Lejweleputswa (Welkom)Thabo Mofutsanyana (Phuthaditjhaba)Fezile Dabi(Kroonstadt) ---Mopani (Giyani)Vhembe (Thohoyandou)Capricorn (Polokwane)Waterberg (Bela-bela)Sekhukhune (Groblersdal) ---Ugu (Port Shepstone)Umgungundlovu (Pietermaritzburg)Uthukela (Ladysmith)Umzinyathi (Dundee)Amajuba (Newcastle)Zululand (Ulundi)Umkhanyakude (Mtubatuba)UThungulu (Richards Bay)iLembe (Kwa Dukuza)Sisonke(Ixopo)Ethekwini (Durban) ---Namakwa (Springbok)Pixley-ka-seme (De Aar)Siyanda (Upington)Kgalagadi (Kathu)Frances Baard (Kimberley) ---Bojanala (Rustenberg)Central (Mafikeng)Bophirima (Vryburg)Southern (Klerksdorp) ---Gert Sibande (Standerton)Nkangala (Witbank)Ehlanzeni (Nelspruit) Use the 'Choose File' button below to attach a copy of your ID (Only .png, .pdf or .jpg files, max 3mb) Use the 'Choose File' button below to upload a recent ID/Passport type photo (Only .png or .jpg files, max 3mb) If you have already made payment, please use the 'Choose File' button below to upload proof of payment. Alternatively, please email proof of payment as per instructions on the next page (Only .png, .pdf or .jpg files, max 3mb)