BLACK BELT GRADUATION REGISTRATION

Name*
Email*
Phone Number*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Date of Birth*
Gender*
Current Rank*
Testing for*
Those testing for 2nd Dan and higher, please enter the date of your last Dan test:
Martial Arts World School Name*
Hidden
Martial Arts World School Name
Master/Instructor Name*
Parent/Guardians name if Child is testing
Upload your Passport type photo here (JPEG):*
Accepted file types: jpg, png, Max. file size: 64 MB.
Children who are testing, upload a copy of your most recent report card here (JPEG or PDF):
Max. file size: 64 MB.
Children who are testing, upload a Parent Appreciation Letter (JPEG or PDF):
Max. file size: 64 MB.
What are the 5 Pillars of True Success?*
Explain each pillar.
What are the 5 powers of self defense?*
Explain each power.
What are the top 10 successful habits?*
What is Martial Arts World?*
What is Martial Arts World philosophy?*
What 3 important benefits did your receive from Martial Arts World?*
Which 2 people would benefit from practicing at Martial Arts World?*
What is your goal with Martial Arts World?*
Additional questions for children.
Who is your best friend?*
Who is your hero?*
Who cleans up your room and washes your clothes?*
How do you handle someone who tries to fight with you?*
By signing below you are acknowledging that you have your Master/Instructors permission to Black Belt Graduate.
Signature*