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1971-2010
Celebrating 39 years of service to our Members!
 
George E. Anderson
1931-2009
 


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Ju-Jitsu Leader Survey

Please use this form to tell us a little about yourself and your Ju-Jitsu activites.

Please note that the information you provide will NOT be released to any outside source, sold, or nor will your privacy be invaded in any way.

Fields with an asterisk * are required.

Name:*
Email:*
Mailing Address:
City: State: Zip:
Home Phone:
Work Phone:
Fax Number:
Ju-Jitsu Style or System:
Your Ju-Jitsu Rank:
Your Age:
Years you have trained in Ju-Jitsu:
Name of your Club or School:
Are you currently affiliated with any Ju-Jitsu organization?
Yes No
If Yes, which Organization?
Are you current teaching Ju-Jitsu or a similar Martial Art?
Yes No
If you are teaching, how many students do you presently have?
How many Ju-Jitsu Black Belt students do you have?
Would you be interested in providing Leadership to organize a USJJF Regional Ju-Jitsu Organization in your area? 
Yes No
Would you be interested in serving on the USJJF Board of Directors?
Yes No
Is there a particular USJJF Committee or Function you would like to serve on?
Yes No
Are you available to travel to USJJF National Events and/or JJIF International Events?
Yes No
Are you currently working on any special projects (i.e. community outreach) in your Martial Art(s) system?
Yes No
Are you interested in receiving Ju-Jitsu Referee Training and becoming a certified USJJF/JJIF Refereee
Yes No
Would you be interest in hosting a USJJF Referee Course (12 hour-Weekend) at your Dojo?
Yes No
Are you currently conducting or hosting Ju-Jitsu Competitive Events
Yes No
Do you have access to facilities that could be used for Ju-Jitsu Competition or Seminars?
Yes No
If Yes, Please describe:
Is there any USJJF Project that you would like to work on individually or in a Committee Work-Group?
Yes No
If Yes, Please comment:
Would you like for us to mail you information on USJJF Membership? (If so, please make sure you provided a valid mailing address above):
Yes No

If Yes, make sure your mailing address is listed above
May we contact you concerning USJJF Membership?
Yes No
Do you have any comments or suggestions that would enhance the USJJF's growth and service to its Members?
Do you have any other comments or suggestions to the USJJF Board of Directors, President or other Officers at this time?

Please click the Submit Survey button to complete the survey.

 

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