APPLICATION FORM

World Headfounder / Headfamilies Council , Inc.

* please FILL OUT COMPLETELY.

NAME_________________________________________________________

ADDRESS : ________________________________________ST./Rd./Ln/Blv.

ADDRESS :________________________________________City/Town/RR

ADDRESS :________________________________________City/Town

ADDRESS :______CountryZip Code

PHONE # ( ........)_-________

AGE_______ D.O.B._ SEX____________

MARITAL STATUS DEPENDENTS_________

OCCUPATION__________________EMPLOYER_________________________________

EDUCATIONAL BACKGROUND

Enclose RESUME containing all ACADEMIC ACHIEVEMENTS with copies of grades & certificates ! (include any/all courses taken including trades, employment sponcered, etc.)

LIFE ACHIEVEMENTS

Enclose DOCUMENTATION (complete with evidence ) attesting to your achievements in life *** This must include photocopies of all possible support for your social , recreational , sport, , political , technical , professional , adminstrational and other achievements in your personal life !

NOTE ** ALL INFORMATION IS KEPT STRICTLY CONFIDENTIAL

MARTIAL ARTS BACKGROUND

Send complete history complete with copies of all ranks , grades , awards, positions, ect.. in the martial arts. ( The more complete the resume, the better we can decide at what level you will qualify in our organization .)

SEND ALL INFORMATION TO THE WHC, Inc

C/O Prof.Thomas Burdine,919 N.12th St., Lafayette, IN, 47904 USA

or email it to : emileg@hotmail.com