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    BB Grading Form - 1.12.2023 Kde

    Uploaded by

    Azman Yusof
    This document is a registration form for a black belt grading examination to be held on December 1st, 2023 at Kelab Darul Ehsan in Ampang. It requests information such as the applicant's name, ID number, current rank, rank applying for, instructor details, and includes waivers of liability. There is a section for payment receipt and signature of applicants and parents of minors. The deadline for submission is November 17th, 2023.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    BB Grading Form - 1.12.2023 Kde

    Uploaded by

    Azman Yusof
    121 views2 pages
    This document is a registration form for a black belt grading examination to be held on December 1st, 2023 at Kelab Darul Ehsan in Ampang. It requests information such as the applicant's name, ID number, current rank, rank applying for, instructor details, and includes waivers of liability. There is a section for payment receipt and signature of applicants and parents of minors. The deadline for submission is November 17th, 2023.

    Original Description:

    BORANG TAEKWANDO

    Original Title

    BB GRADING FORM - 1.12.2023 KDE

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    This document is a registration form for a black belt grading examination to be held on December 1st, 2023 at Kelab Darul Ehsan in Ampang. It requests information such as the applicant's name, ID number, current rank, rank applying for, instructor details, and includes waivers of liability. There is a section for payment receipt and signature of applicants and parents of minors. The deadline for submission is November 17th, 2023.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    121 views2 pages

    BB Grading Form - 1.12.2023 Kde

    Uploaded by

    Azman Yusof
    This document is a registration form for a black belt grading examination to be held on December 1st, 2023 at Kelab Darul Ehsan in Ampang. It requests information such as the applicant's name, ID number, current rank, rank applying for, instructor details, and includes waivers of liability. There is a section for payment receipt and signature of applicants and parents of minors. The deadline for submission is November 17th, 2023.

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    © All Rights Reserved
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    GRADING: NEW BELT: OTHERS: TOTAL :

    RM RM RM
    BLACK BELT GRADING RM
    KELAB DARUL EHSAN, AMPANG
    1 DECEMBER 2023 @ 8.00 am CURRENT GRADE Please attach the following :
    pls tick ( √ ) Latest 2 passport size photos (write name on the
    1st Grade back of photographs & DO NOT staple)

    1st Dan/Poom Photocopy of IC/MYKID


    Closing date : 17/11/2023 Photocopy of current Dan/Poom/1st Grade Certificate
    2nd Dan/Poom

    Photocopy of 2023 TM BB Membership card (for 1st


    Full Name as per IC/MYKID Black/Poom above)
    (in capital letters) .

    IC/MYKID No: Date of Birth:

    Gender: Contact No:


    Please submit photocopy IC
    TM Reg BB No: Present Poom/Dan:

    Address:

    Date Obtained Present Poom/Dan Apply for:


    Poom/Dan:
    Instructor’s Name: Training Centre

    I am aware of the possibility of my son/daughter/ward being injured during the Black Belt Grading and I hereby undertake and
    agree to that I will not attach any blame or bring civil proceedings against KORYO TAEKWONDO CLUB, INSTRUCTORS, SCHOOL
    AND MY FELLOW MEMBERS.

    ____________________________ _______________________
    Applicant’s Signature Date

    FOR MEMBER UNDER 18 YEARS OF AGE

    I, ________________________________________________________________ NRIC No: __________________________


    As parent/guardian, do hereby allow my *son/daughter/ward to participate in the above grading examination, I fully
    understand and agree with the above-mentioned conditions.

    ___________________________ _______________________
    Parent’s /Guardian’s Signature Date

    NOTE: 1st Poom/Dan & above must be a registered TM Black Belt for the year 2023. Ensure the age and the time limit criteria
    for Dan Promotion are sufficiently before applying. Closing date for submission before or by 17/11/2023
    ................................................................................................................................................. ..............................................

    Payment Receipt
    Grading Date : 1 DECEMBER 2023 @ KELAB DARUL EHSAN, AMPANG

    1st Grade to 1st Poom/Dan


    Received from
    1st Poom/Dan to 2nd Poom/Dan
    the sum of RM being the payment of grading fee. 2nd Poom/Dan to 3rd Poom/Dan
    Others
    _____________________
    Received by: Date :
    Taekwondo Malaysia (WTF)
    BLACK BELT/POOM PROFILE & REGISTRATION FORM
    (Kindly print clearly when filling up the form)

    REGISTER NO. TM

    APPLICATION FORM FOR REGISTRATION OF:


    1. NEW BLACK BELT 2. NEW POOM

    FOR THE YEAR 2 0 2 3

    I hereby apply for my registration as a Black Belt / Poom and agree


    to abide by the Constitution and Rules and Regulations of the Taekwondo Malaysia ( WTF ).

    Full Name:
    (Tick) D D M M Y E A R
    NRIC/B.CERT Sex M F Date of Birth:

    Occupation:

    Address:

    Pos Code: City State

    Tel: Fax

    Name of State
    / Club : K O R Y O T A E K W O N D O C L U B

    Dan Reg.No(Previous) Kukkiwon No


    Poom T M

    Payment: RM Email

    I, the above named, hereby accept the TM Constitution and By-laws and apply to be registered with the Taekwondo
    Malaysia (TM/WTF) and I declare that the information given above are true and current to best of my knowledge.

    Signature of parent/Guardians Signature of Applicant

    Full Name :

    I.C No.:

    Date:

    (OFFICIAL USE ONLY)

    The above application for registration as (a) Black Belt is APPROVED REJECTED
    (b) Poom is APPROVED REJECTED

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