Registration Form for
		The 3rd Annual Aikido-L Seminar - 2000

	   October 7-8, 2000 at the Boulder Aikikai dojo in
			  Boulder, Colorado

(Please type or print, and use a separate form for each attendee)


 Last Name:______________  First Name: _______________  Middle Initial:  _____


 Dojo:  ___________________________  Rank: ______________  Sex:   (  F  /  M  )


 MAILING ADDRESS:

 Street:  _________________________________________________ Apt #:  __________

 
 City:  _________________ State/Province:  ___________ ZIP/Postal code: ______


 Country: ______________________________


 E-mail address:  __________________________ Telephone (opt):  _______________


 Fee enclosed:  (please check one) 

   [  ]  - US$40 - Early registration (postmarked prior to October 1, 2000)
   [  ]  - US$50 - Late registration (postmarked later than October 1, 2000  
                                      or at the door)

 Please note that there will be no refunds.  Registration spots may be
 transferred with the consent of both parties registering and with
 notification to Jun.

 Please make payments payable to Jun Akiyama, and mail to:

        Jun Akiyama
        c/o Boulder Aikikai
        2424 30th Street
        Boulder, CO  80301
        USA


 Signature:  ____________________________________ Date: ______________________


T-Shirts: (circle sizes desired and indicate quantity of each):

            NONE   S____   M____   L____   XL____   XXL____

 (NOTE: T-shirt not included with registration.  We're just trying to get
  a size-distribution, and desire estimate for ordering purposes.)