Become an Affiliate

                   Daniel Tavares Academy

                    Association Application




Full Applicant’s Name: ______________________________ Date of birth: _____/_____/_____

School Name: __________________________ School Address: __________________________

City: __________________ State: ______ Zip Code: ____________ Years in Business: ________

 School’s Website: http://___________________________________

Telephone Number: (_______) _______-_________

How long have you been at your current location? ________________________

How far is your school from the nearest Brazilian Jiu-Jitsu School? __________________

How much mat space is available for grappling? ______________________

Number of instructors at your school: _____ Approximate number of students enrolled? ______

Please describe all martial arts styles taught at your school: _______________________________________________

Is grappling currently taught? ________

Give us a brief description of your facility: ______________________________________________________________________________


Do you have a general liability insurance policy? ______ Do you authorize us to conduct a background check? ______

Comments and Questions: ___________________________________________________________________________________



Signature of Applicant: ________________________________________________

Date: ______/______/______

The completion and submission of this application in no way constitutes an agreement by either party and involves no obligations of any kind.

Mail or bring to the academy:

Daniel Tavares Brazilian Jiu Jitsu Academy

Address: 2903 New Brooklyn Erial Rd, Sicklerville, NJ 08081 – USA

Or call us for more questions: (856) 885-3675