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This program is intended for people who wish to be basic kubaton trainers
PLEASE READ THIS BEFORE FILLING OUT THE FORM
Certification Information Form
First Name:
Last Name:
City and State:
E-Mail Address:
Age:
Martial Arts Experience:
Law Enforcement Experience:
Medical Responder Experience:
Security Professional Experience:
Other Related Experience:
Current Occupation:
Courses you will teach involving the use of the kubaton:
Estimation of current kubaton proficiency:
Additional comments:
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