International Martial Arts Group
Application for Black Belt Exam and Graduation

Name_____________________________________________

Address___________________________________________

Email_____________________________________________

Age_________________   Date of Birth_______________________________

Current Rank__________________________________________

New Rank Requested____________________________________

Size of Belt___________

Color of thread___________  only one color please 

Things to have completed:

Thesis Paper____________
TKD Resume____________
Number of classes________
Classes Taught___________
Time in Rank____________
Time in TKD____________
Seminars Attended_______
Tournaments Attended_________
Testings Attended________

Signed__________________________________________________  Date_____________

Printed Name____________________________________________  Date_____________