Colour Belt Grading Application

Applicant's Name: *Please complete a separate application for each person in your family.
Age:
Parent's Name (if applicant is under 18 years of age)
Home Phone
Mobile
Email: *
Grading Date
Please select the grade applied for
Grading Fee (please enter amount to pay) Grading fees are listed above. Family discounts: 2 people in a family at the same grading get a $25 discount, 3 people in a family at the same grading get a $50 discount. Family Fee Cap: Maximum grading fee for a family of 2 or more at the same grading is $120.
Payment
The grading can be paid at club, or by internet banking into account: BNZ 020358 0202651-03.CashChequeInternet Banking
Upload Scan (optional) You can scan (or photograph with your phone) the completed Workbook page and/or Report and upload it here rather than bring it in for signing off.
Terms & Conditions *
DECLARATION I hereby request to be tested for promotion. I understand that the examiner shall be the only person who is qualified to promote me or fail me on the basis of my technique, knowledge of the art, and attitude. I understand the grading fee does not guarantee my promotion. The grading fee will be paid prior to the grading date and my training fees are also up to date. I have read and accept the above conditions.AGREE