UK Licence Application

Full Name	Date of birth Occupation
Address
Telephone	Mobile Email
Club Name	Instructors Name
present grade	style last grading date
Tick Licence applying for	Student Licence @ £20 Blackbelt Licence @ £25 Instructor Licence @ £25
Tick Box	Student Member Certificate @ £5 Blackbelt Member Certificate @ £8 Instructor Member Certificate @ £10
Have you applied for a WUMA Licence before: Yes No WUMA Licence If yes give old Licence number
Comments
	We accept all major Credit Cards and Debit Cards (Switch etc). Fill in the form below and press the Submit button - this will email all your details direct to us
Cost: As above plus a £5 online charge for administration-postage-card bank percentage Attention: Without full payment we cannot forward your application
Card Type
Card Number	Security code (last 3 digits on signature strip on back of card)
Expiry Date	MM YYYY Your post code for added card security:
Issue Number
Cardholder Name
Please double check that all the details are included and are correct. Click the Submit button below ONCE. As soon as we receive this information the Licence will be processed within one week. Many Thanks!