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Testing Information Paper

 

Student Name:                                                                            

Testing Month:                                                                            

Current Rank:                                                                                  

New Rank:                                                                                

Tai Chi ______      Kendo ______        Gung Fu ______

Belt Rank Order:  white, orange, yellow, camo, green, purple, blue, brown, red, red/blk, BLK

 
Little Dragon Belt Size:                    

_____ Child SM (uniform size 000, 00) 

_____ Child LG (uniform size 0, 1, 2)                                                     

Adult & Junior Belt Size: (same as their uniform size, circle one)    

0        1           2           3           4           5           6          7         8

 

Blk Blt Midterm # 1        2       3       4       5      6      7        8      9         

(Circle one)            10     11     12     13     14    15     16     17     18

 

Program: (Circle one)     Basic       BBT        MT         LP  

Cost:              $35 each student    

Family Rates:  $10 for each additional family member (3rd, 4th, etc)

 

Testing fees due: if fees received after due date  
$10 late fee will be assessed

 

Use Credit or Debit Card on file?                           

 

IF YOU NEED TO TEST EARLY SEE AN
INSTRUCTOR. EXTRA FEESAPPLY!