US-ITF Membership Kit: download

UNITED STATES
INTERNATIONAL TAEKWON-DO FEDERATION
NATIONAL HEADQUARTERS
President Master Robert N. Wheatley
P.O. Box 33205
Reno, NV 89533
PHONE 775-826-2355
MEMBERSHIP APPLICATION
Please print or type application. Name will appear on cards as it appears on this application.
Last Name _______________________________ First Name ______________________________
Address __________________________________________________________________________
City ___________________________________State ____________ ZIP CODE_______________
Present Rank _____________
Black Belt Certificate no. _________________________________
(if ITF Certified)
Male
Female
Age _________
Telephone # (_____) ______________ e-mail: _______________________
Date of Birth _____________________________
Your Instructor’s Name __________________________ School ____________________________
Instructor’s Rank ____________________________ Is he / she ITF Certified? Yes
Do you practice ITF patterns ?
Yes
No
Annual Membership Fee $25
Please mail this form to:
USITF
c/o Mr. Gordon Jue
5460 Sunol Blvd. #8
Pleasanton, Ca 94566
Return application and fee to your instructor.
Make check payable to your Instructor or representative of the USITF
No
UNITED STATES
INTERNATIONAL TAEKWON-DO FEDERATION
NATIONAL HEADQUARTERS
President Master Robert N. Wheatley
P.O. Box 33205
Reno, NV
89533
PHONE 775-826-2355
SCHOOL
MEMBERSHIP APPLICATION
NAME _________________________________________INSTRUCTOR’S RANK ___________
HOME ADDRESS _______________________________________________________________
SCHOOL NAME ________________________________________________________________
ADDRESS ______________________________________________________________________
HOME PHONE ________________ SCHOOL PHONE ______________ FAX _____________
INSTRUCTORS NAME & RANK __________________________________________________
INSTRUCTOR’S ITF BLACK BELT CERTIFICATE NUMBER ________________________
Please! Include a brief history of your Taekwon-Do training as well as copies of all certificates and
one passport photograph, along with a list of all instructors in your school.
After reviewing the above requested information, and if approved, membership numbered USITF
plaque will be sent as soon as possible.
All Black Belt students from other organizations need to be recommended by an officer of the
USITF.
FIRST TIME MEMBERS $150.00
ANNUAL MEMBERSHIP FEE: $75.00
Please make checks payable to:
United States International Taekwon Do Federation
Please mail this form to:
USITF
c/o Mr. Gordon Jue
5460 Sunol Blvd. #8
Pleasanton, Ca 94566
United States
International Taekwon-Do Federation
Grade (gup) Test Form
Name (The way it will appear on your certificate)
Please Print (Adults Fill Out For Minors)
Age
phone #
Address
City
State
Do- Jang
Instructor
Current Rank
Rank Testing For
Test Fee
ITF No.
Zip
Test Date
Paid by:
Cash Check Credit Card
Time Since Last Test
I hereby request to be tested for promotion and agree that the judges shall be the only persons who are qualified to promote me or fail me on the
basis of my technique, knowledge of the art and attitude. I also understand that I must have written permission from the master instructor to attempt
to skip rank or to miss the tournament part of the testing when it is required. I also agree that I will not engage in the business of instruction or other
activities of the United States International Taekwon-Do Federation without the written permission of this organization.
Parent's Signature (if the student is under the age of 18)
Student's Signature
DO NOT WRITE BELOW THIS LINE (THIS SECTION FOR EXAMINER ONLY)
Examiner's Name
Test Category
Examiner's Recommendation
Grade
Comment
Hand Combinations:
Basic Kicks:
Multiple Kicks:
Flying Kicks:
Step Sparring:
1 2 3 Semi Free
Basic Intermediate Advance
Examiner's Signature
Instructor's Signature
Testing Category
Grade
Comment
General Manner
and Appearance
Required Pattern # 1
Required Pattern # 2
Required Pattern # 3
Choice Pattern
General Knowledge
History, Philosophy
Ho Sin Sul
Required Break #1
Required Break #2
Required Break #3:
Sparring
Results of examination
Fail
Incomplete
Pass
United States International Taekwon-Do Federation
President Master Robert N. Wheatley
PO. Box 33205
Reno, NV
89533
PHONE 775-826-2355
Dear Instructor,
Welcome to the United States International Taekwon-Do Federation. Enclosed you will find a
brief history of the USITF, a guide line on protocols, school and individual membership
application. Feel free to make as many copies of the applications for you and your students as
you require.
As a quick summary of the USITF... The United States International Taekwon-Do Federation is
an official governing body for the International Taekwon-Do Federation (ITF). All standards are
those set by the ITF and the USITF. Students testing under a certified ITF instructor / testing
board are recognized Nationally and Internationally. Some of the events you will find with the
USITF / ITF are:
•
International, National, Regional, State, and Local tournaments throughout
the year
•
International, National, and Regional Summer Camps
•
Seminars
• Business Seminars
• International instructor's courses
• Referee seminars
• Instructor's course
• Regional, State and Local seminars
Memberships
• Individual membership receives the following:
• 1 ITF patch
• USITF and ITF identification cards
• Members are entitled to have free lessons at Taekwon-Do schools
throughout the world that are registered with the I.T.F. outside their
own town of residence.
• School membership
• Receives an ITF recognized school certificate
• Interested students in your area will be given your school name,
address, phone, and contact
• Be able to host International, National, and local events
• Other benefits for being a school member
I look forward to talking and meeting with you in the near future. Please feel free to contact me
at (925) 484-0308. Thank you.
Yours In Taekwon-Do,
Mr. Gordon Jue, VI Dan
USITF - Vice President of Business Affairs