AMAA

“BREAKING BARRIERS ~ ONE MOVE AT A TIME”

The Adaptive Martial Arts Association is the nations leading 501c3 non-profit organization promoting disabled inculcation in martial arts through education and support. 

School Search Assistance Request Form


Name *
Name
Address *
Address
Phone Number *
Phone Number
Is the request for assistance for person filling out this form? *
What is your preferred travel distance to class? *
What type(s) of disability does the potential student have? *
Does the potential student use any assistive devices (Example: Wheelchair, Walker, Braces, Hearing Aids, Crutches, White Cane, Prosthetics, Etc.) *
Has the potential student ever practiced martial arts before? *
Does the potential student have a specific style they would prefer to learn? (Please Note: Althought we will try our best to place you in you style of preferance, some disabilities are suitable for certin styles than others) *
Is this potential student on a fixed income and would he/she benefit from a class tuition scholarship or transportation scholarship? (If you answer "Yes" to this question, someone will contact you about possible financial assistance eligibility) *
Would you be willing to participate in a "Follow-Up" Survey? (If you answer "Yes" to this question, someone will contact you 90 days after you are connected with a school requesting completion of a short servey) *
How did you learn about our organization? *

 

Adaptive Martial Arts Association

“BREAKING BARRIERS ~ ONE MOVE AT A TIME”

(802) 747-8184

contact@adaptivemartialarts.org

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