IFPA

DETAILS of the APPLICANT MEMBER

Name of the National Pankration Body :

Full Address:

Phone number:

Fax number:

E-mail:

Web Site:

Name of the National Representative:

Phone number:

Fax number:

E-mail:

Name of the Executive Committee President

Phone number:

Fax number:

E-mail:

Name of the Vice President

Phone number:

Fax number:

E-mail:

Name of the Vice President

Phone number:

Fax number:

E-mail:

Name of the Secretary General

Phone number:

Fax number:

E-mail:

Name of the Treasurer

Phone number:

Fax number:

E-mail:

Name of the Executive Member

Phone number:

Fax number:

E-mail:

Name of the National Coach

Phone number:

Fax number:

E-mail:

Name of the National Referee

Phone number:

Fax number:

E-mail: