Shaolin Lohan School of Kung Fu
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*Full Name (First MI. Last): *Email address: *Which programs are you interested in? (Check all that apply)Children's Program (Little Lohans)Pupil ProgramDisciple ProgramProfessional Ring CompetitionShaolin Lohan Pai Lion Dance TroupeTai Chi for Health & LifeDragon Investigative Security Corps (D.I.S.C.)*Which location are you interested in attending?Saint Louis, Missouri (Main School)Springfield, MissouriKansas City, Missouri*Date of Birth (Month-Day-Year): *Phone Number (Primary): *Address (Street): *Address (City): *Address (State): *Address (Zip Code): *How did you hear about us?PupilDiscipleInternetYellow PagesOtherIf you heard about us from a Pupil or Disciple of the Shaolin Lohan School of Kung Fu; what is that student's name? Do you have anything to add? (Place additional comments here):*I certify that I am at least 18 years old and I understand that I may be required to provide my Social Security # at the time of my interview.Yes
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