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® International Taekwon-Do Federation ®
APPLICATION FOR DEGREE CERTIFICATE
APPLICANT:
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FORENAME / SURNAME / Mr / Mrs / Miss
HOUSE / APT / NAO or INO Number *
STREET / STATUS CARD No. *
PLACE OF BIRTH
TOWN / NATIONALITY *
CITY / DATE OF BIRTH / DD/MM/YYYY
ZIP / HEIGHT
COUNTRY / WEIGHT
OCCUPATION / EYE COLOUR
EDUCATION / HAIR COLOUR
DEGREE APPLIED FOR / GRADING DATE / LOCATION
For IVth Degree Only
a / DAY/MONTH/YEAR
DATE HISTORY / THESIS SENT / INSTRUCTOR
Current Certification:
a / Degree
ITF CERTIFICATE NUMBER / Signature:
Months since last grading / EXAMINER
Courses Attended: (If necessary continue overleaf)
a / Degree
CERTIFICATE NUMBER / DATE / Signature:
DAY/MONTH/YEAR / ASSOCIATION PRESIDENT / AUTHORISED DEPUTY
DAY/MONTH/YEAR / Degree
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AFFIX
CURRENT
PHOTO
/ Affix one photograph to the left where indicated. / Signature:
DATE SIGNED / DAY/MONTH/YEAR
* Please see guidance notes over leaf.
The Society for Orthodox Taekwon-Do® is registered as a non-profit organisation.
Administration: Yiewsley Leisure Centre, Otterfield Rd. West Drayton, Middx. UB7 8PE ENGLAND Tel. 00 44 1895 427356 Fax. 00 44 1895 420822
○ www. itf-administration.com
GUIDANCE FOR APPLICANTS
· Please ensure that all items are appropriately & accurately completed.
· It is requested that all details are typewritten. (PC templates are available on request from ITF H/O if required). If this form is hand written, the ITF will not be responsible for any certificate printing errors and replacement/amended certificates will be charged at $30.00.
· Only one nationality should be entered, that being the nationality stated in the applicant’s passport. In the case of the applicant having ‘dual’ nationality, only the nationality that most accurately reflects the applicant’s citizenship should be entered.
· Only one forename & surname should be entered as there is not usually enough room for more on the certificate. If more than one is entered, without any explanation provided, the certificate may not be printed with the entire name. The ITF will not be responsible if this occurs and replacement/amended certificates will be charged at £30.00.
· ‘N.A.O. or N.O. Number’ refers to the registration number of either the Nationally Amalgamated Organisation or National Organisation (as appropriate) of which the applicant is a current & paid up member.
· Every black-belt must have a current status card. Thos without a valid status card are not permitted to grade.
· Personal history & thesis are requirements for grading to IVth Degree. These should be submitted to the ITF at least 3 months in advance of the grading date for approval. The thesis should be about Taekwon-do. It could be what you think about Taekwon-do at the present, or how you see it developing in the future. Alternatively it could be about any part of Taekwon-do such as warming up exercises or patterns. It could also be about the anatomy in connection with Taekwon-do.
· Failure to comply with any requirement will result in permission either being withheld or withdrawn for you test.