Name

First Name

Last Name

Have you met the minimum time requirements for promotion? *

Yes

No

Have you met the minimum seminar requirements for promotion? *

Yes

No

Not applicable

If you answered no to either of the above questions, have you discussed time and seminar requirements with Josh Sensei? *

Yes

No

Not applicable

Are you confident you know the required techniques? *

Yes

No

Are you confident you know the required ki exercises, tai sabaki, and weapons? *

Yes

No

Select your test date *

MM

DD

YYYY

May we bill your $60 test fee to the card on file? *

If no, please be have an alternate form of payment available at the time of your test.

Yes

No