Japan Karate Association of New Mexico
Information request
If you need to cancel your Tryal class please check the end of this form and re-register this form again.
Your Name
*
Trial person's name
*
First
Last
Trial person's Gender
Male
Female
Trial person's age
*
Choose one
3
4
5
6
7
8
9
10
11
12
13
13+
21+
Email
*
Phone Number
*
###
-
###
-
####
Do you want to try a free class?
*
Yes
No I just want to watch a class
No i just want to talk to you
Who will be trying class?
*
Choose one
Myself
My child
My family member
My friend
Type of Class you are looking for.
*
Choose one
Kindar Karate Age 3-6
Children Class Age 6-13
Adult Class 14+
When would you like to visit a class or just to talk?
*
MM
/
DD
/
YYYY
What time?
*
Choose one
10:00am-12:00pm
After 4:00pm
I do not know
If you cannot come this week, how soon would you like to try a class?
Choose one
Next week
In two weeks
Have you study karate before?
*
Yes
No karate, but other martial art
No
Why have you chosen Karate or/and our dojo?
How did you find us?
*
Internet
Friend
This dojo member
Phone Book
Driving by
New Mexico Kids ad
North Star ad
Others
Cancelation
Yes I need to cancel the tryal class
Yes I need to cancel visiting your dojo
Please re-submit your information request form for the cancelation
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