BLACK BELT TESTING
BLACK BELT REGISTRATION
Black Belt Testing Application
Address Line 2
State / Province / Region
ZIP / Postal Code
Date of Birth
Those testing for 2nd Dan and higher, please enter the date of your last Dan test:
Martial Arts World School Name
Parent/Guardians name if Child is testing
Upload your Passport type photo here (JPEG):
Children who are testing, upload a copy of your most recent report card here (JPEG or PDF):
What is the main difference between Ordinary and Successful people?
How can you become a Leader Not a Follower?
What are the 2 steps to create a Successful GPS?
What does D.D.D.P.E. mean?
What is your personal dream?
What are the 5 pillars of true Success?
What is Harmony and Balance?
How do you build Physical Fitness?
How do you build Mental Fitness?
How do you build Moral Fitness?
How do you build Financial Fitness?
How do you build Life Fitness?
What are the top 10 Successful habits?
By signing below you are acknowledging that you have your Master/Instructors permission to Black Belt test. After signing and submitting you must complete payment to be registered for Black Belt testing.
BLACK BELT TESTING EARLY REGISTRATION
1ST DAN "3RD FAMILY MEMBER"
2ND DAN "3RD FAMILY MEMBER"