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Get University of California Martial Arts Program Club Enrollment Form

G Club Enrollment Form General Information *Last Name: __________________________ *First Name: _________________________ *MI: _____ *Club Membership: Judo Karate Taekwondo Taiji *Choose One: New Member Renewal Renewal with changes Birthdate: _______________ Membership Type: Youth UCB Student Gender: UCB Alumni Male UCB Staff/Faculty Wushu Yongmudo Female Community/Extension Student ID#:____________________ (if UCB Student) Local Address: ________________________________________.

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