Application for dan and kyu grades

APPLICATION FOR DAN AND KYU GRADES

AIKIDO WITH MIND AND BODY COORDINATED

(FILL IN ALL INFORMATION BELOW THIS LINE.

PLEASE PRINT OR TYPE.)

DO NOT WRITE HERE.

FOR OFFICIAL USE ONLY.

CERTIFICATE NO _____________________

GRADE GIVEN: ________DAN _______KYU

MEMBERSHIP CARD NO.:	DATE OF MEMBERSHIP:
NAME:	DATE OF BIRTH:
	ADDRESS:	SEX: Male Female
OCCUPATION:	NATIONALITY:
PRESENT RANK: DAN KYU	NAME OF DOJO / SENSEI: Belarus Ki-Aikido Society/ Yury Huk
DATE PRESENT RANK OBTAINED:	WHERE PRESENT RANK OBTAINED:
DATE OF EXAMINATION:	EXAMINER’S SIGNATURE:

I HEREBY MAKE MY APPLICATION FOR DAN KYU.

SIGNATURE:__________________________________

APPLICATION FOR KI DEVELOPMENT GRADES

SHIN SHIN TOITSU DO

(FILL IN ALL INFORMATION BELOW THIS LINE.

PLEASE PRINT OR TYPE.)

DO NOT WRITE HERE.

FOR OFFICIAL USE ONLY.

CERTIFICATE NO _____________________

GRADE GIVEN: ________DAN _______KYU

MEMBERSHIP CARD NO.:	DATE OF MEMBERSHIP:
NAME:	DATE OF BIRTH:
	ADDRESS:	SEX: Male Female
OCCUPATION:	NATIONALITY:
PRESENT RANK: DEN KYU	NAME OF DOJO / SENSEI: Belarus Ki-Aikido Society/ Yury Huk
DATE PRESENT RANK OBTAINED:	WHERE PRESENT RANK OBTAINED:
DATE OF EXAMINATION:	EXAMINER’S SIGNATURE:

I HEREBY MAKE MY APPLICATION FOR DEN KYU.

SIGNATURE:__________________________________

Дата добавления: 2015-11-04