Before adding to the shopping cart and checking out on PayPal's secure page, please submit the required information listed below. (English Text Only) *(denotes required field) ■ First Name: * ■ Last Name: * ■ E-Mail Address: * ■ Extra E-Mail Address: * This is to be used in case we can not reach you.Gmail is recommended. □ URL of your School/Organization (if any): Just for our translating and designing reference. ■ Layout Format (Landscape only): * Letter Tabloid A4 A3 Please select one. ■ Border Design: * Dragon Phoenix Tiger Tiger vs Dragon No Border (blank) Please select one. View Borders ■ Japanese Text Font: * Font1 (preferred) Font2 Font3 Please select one. View Fonts ■ A. Heading Text: * View Text Items ■ B. Name of the Award Recipient: * One person's name. View Text Items □ Name Pronunciation Guide: Required if the name is pronounced in non-English,or difficult to read. ■ C. Awarded Rank or Title: * e.g. "6th Dan" View Text Items ■ Label Text: * ■ D. Award Text: * default: This is to recognize that the person mentioned above is hereby licensed to rank in the grade of the specified rank of (style of the Art) in recognition of the great progress that he or she has made by the diligent study of the Art. Please be in 50 English words. View Text Items ■ E. Date of Award: * View Text Items □ Date Format: N/A Month/Day/Year Day/Month/Year Year/Month/Day If the above is written in numerical notation,please select one. ■ Label Text: * □ F. Name of Organization: If any. View Text Items ■ Martial Arts Style: * e.g. "Shoto Karate" ■ Name of the school, class, dojo etc.: * ■ G. Signature line(s) for Instructor(s): * One line (default) Two lines Remove the line Please select one. View Text Items □ Below-the-line Label Text: If any. ■ H. Name of the Conferrer: * One person's name. View Text Items □ Name Pronunciation Guide: Required if the name is pronounced in non-English,or difficult to read. □ Title of the Conferrer: If any. e.g. "Hachidan/Shihan" ■ Hanko Stamp Image 1 (School Name): * Positive Type Negative Type None (blank) Please select one. View Items ■ Hanko Stamp Image 2 (Conferrer): * Surname only Surname and Brief Tittle None (blank) Please select one. □ Brief Title (if any): If any. Please be in brief. e.g. "Sensei" ■ Logo Image: * Default Image Customer's Image None(Blank) Please select one. View Items If you chose "Customer's Image",please send the image file via e-mail to us later.For details, please refer to the confirmation e-mail. ■ Watermark: * None Same as the Logo image Another Image Please select one. View Items If you chose "Another Image",please send the image file via e-mail to us later.For details, please refer to the confirmation e-mail. □ Additional Description: If any terms of Japanese origin,please let us know about them.e.g. "Bujin Academy" Bujin, meaning Martial God CAPTCHA Code: *