NOMINATION FORM FOR WORLD MARTIAL ARTS BLACK BELT HALL OF FAME

To nominate someone for the Hall of Fame, you may FILL this online form, then click submit or print this form and send to:

PROF. DR. SONG SWEE HEE
Ph.D., A.M.N., P.B.S., A.B.S., FIMARI.,
PRESIDENT,
INTERNATIONAL MARTIAL ARTS RESEARCH INSTITUTE,
P. O. BOX 786,
93716 KUCHING, SARAWAK, MALAYSIA.


PLEASE INCLUDE A BRIEF BIOGRAPHY OF THE NOMINEES (IF AVAILABLE)

I, would like to nominate the following individuals for induction into


NOMINEE NAME:
DATE OF BIRTH:
ADDRESS:
CITY:
STATE :
ZIP:
COUNTRY:
HOME PHONE:
BUSINESS PHONE:
MOBILE PHONE:
E-MAIL:
RANK:
TITLE:
STYLE:
CATEGORY:   [LookUp Category]
BRIEF BIOGRAPHY OF THE NOMINEES