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Welcome new UFAF Affiliate member!

Individual UFAF Affiliate Membership: $125/year OR $11.99/month

PLEASE NOTE: This form is for NEW MEMBERS ONLY. If you already have a UFAF membership through UFAF KM or the UFAF BJJ program, please Log In and add UFAF Affiliate membership from the "Manage Your Membership" link.


CREATE A MEMBER ACCOUNT

Fields in  GOLD  are required.

Contact Info


 First Name

 Middle Name

 Last Name

 Suffix (Jr.,III, MD)

 Address

 Address 2

 City

 State (Ex: TX or Mexico)

 ZIP / Postal Code

 Country

 Home Phone (Ex: 555-123-1234)

 Work Phone (Ex: 555-123-1234)

 Mobile (Ex: 555-123-1234)

Internet Info


 Email Address
 
 Re-Enter Email Address
WILL BE ASSIGNED
Username (Member ID)
 
 Password
http://
Personal Web Site Address (Facebook, etc)

Personal Info

 
Month
 
Day
 
Year
  Date of Birth
         
Feet
 

Inches
  Height


Sex
 
lbs
Weight

Program Info


School

 Instructor First Name

 Instructor Last Name

 Region (same as school above)

     


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