OMAC Annual Registration


Fill out this form to complete the OMAC annual registration
Click here for form instructions and mailing information

First Name:
Last Name:
MI
Sex MaleFemale
Birth Date//
SSN--


Telephone (H): --
Telephone (W):--
OMAC ID#:
US Citizen?:YesNo


Address:
City:
State:
Zip Code


Rank & Belt Color:
OMAC Student Since:
Instructor:
Instructor Rank:




PLEASE NOTE: Payments by Visa and Mastercard are deducted on the 1st or 15th of the month. A 30 day written notice to cease membership is required. Just email us at: choongmoo@hcsattys.com

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