Portland Center: 2904 SE Belmont St., Portland, OR 97214 / (503) 736-9634
 

BLACK BELT APPLICATION FORM
  Test Date:
 
 
 

SECTION I: Personal Information

 NAME:
 ADDRESS:
 PHONE NUMBER:
 DATE OF BIRTH:
 HEIGHT:  UNIFORM SIZE:
 INSTRUCTOR:
 LOCATION OF STUDIO:
SECTION II: Application Requirements
 TEST FEE: $150.00
 PICTURES:  Two passport-sized color pictures
 PAPER: 1st Dan Candidate: Personal History
  2nd Dan Candidate: How to Apply Tenets to Everyday Life
  3rd Dan Candidate: How Taekwon-Do has Influenced Your Life
  4th Dan Candidate:

SECTION III: Due date for application, Test Fee, Pictures and Paper