BLACK BELT MEMBERSHIP APPLICATION FORM (14 years & Under)
BLACK BELT MEMBERSHIP APPLICATION FORM (14 years & Under)
BLACK BELT MEMBERSHIP APPLICATION FORM (14 years & Under)
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<strong>BLACK</strong> <strong>BELT</strong> <strong>MEMBERSHIP</strong> <strong>APPLICATION</strong> <strong>FORM</strong> (<strong>14</strong> <strong>years</strong> & <strong>Under</strong>)Membership Term: September 1, 2007 – August 31, 2008(Please attach a copy of your Kukkiwon Certificate)Personal Information_________________DateName: _________________________________ Date of Birth______________Address: _________________________________________________City: _______________________________ Postal Code: __________________Telephone (res): ____________________ Telephone (bus): _______________Fax: ____________________ E-Mail _________________________________Present Degree (Dan):_______WTF Kukkiwon Certificate # ____________________Do-Jang Information:Your Instructor’s Name:_____________________________________________Name of Do-Jang (where you train):_______________________________________Do-Jang Address:_______________________________________I, _____________________________________, hereby apply for full membership inthe Alberta Taekwondo Association. I undertake to abide by and be subject to allrules, by-laws and regulations of said Association.____________________________________ __________________________________Signature of ApplicantSignature of Instructor____________________________________Signature of MasterATA-<strong>MEMBERSHIP</strong> DIRECTOR: Box 506 STN MAIN, Edmonton, AB T5J 2K1Phone: (780) 988-4444 e-mail: linda.kwan@cra-arc.gc.caApplication Deadline November 30, 2007
<strong>BLACK</strong> <strong>BELT</strong> <strong>MEMBERSHIP</strong> <strong>APPLICATION</strong> <strong>FORM</strong> (<strong>14</strong> <strong>years</strong> & <strong>Under</strong>)Membership Term: September 1, 2007 – August 31, 2008(Please attach a copy of your Kukkiwon Certificate)Personal Information_________________DateName: _________________________________ Date of Birth______________Address: _________________________________________________City: _______________________________ Postal Code: __________________Telephone (res): ____________________ Telephone (bus): _______________Fax: ____________________ E-Mail _________________________________Present Degree (Dan):_______WTF Kukkiwon Certificate # ____________________Do-Jang Information:Your Instructor’s Name:_____________________________________________Name of Do-Jang (where you train):_______________________________________Do-Jang Address:_______________________________________I, _____________________________________, hereby apply for full membership inthe Alberta Taekwondo Association. I undertake to abide by and be subject to allrules, by-laws and regulations of said Association.____________________________________ __________________________________Signature of ApplicantSignature of Instructor____________________________________Signature of MasterATA-<strong>MEMBERSHIP</strong> DIRECTOR: Box 506 STN MAIN, Edmonton, AB T5J 2K1Phone: (780) 988-4444 e-mail: linda.kwan@cra-arc.gc.caApplication Deadline November 30, 2007
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