Philippine Taekwondo Association Promo-Test-Application-Form
Philippine Taekwondo Association Promo-Test-Application-Form
Philippine Taekwondo Association Promo-Test-Application-Form
The undersigned has completed all promotion test requirements and hereby attests that the information below
are true and correct.
Date of Present Examination Age Date of Birth
m m d d y y y y m m d d y y y y
First Name Citizenship / Nationality
Male Female
Middle Name Home Address
Province
Present Grade/Degree LEGEND :
(Please use the legend provided) W - Whitebelt 2nd B - Low Brown
Zip Code
8th Y - Low Yellow 1st B - High Brown
7th Y - High Yellow 1st Poom / Dan Mobile Number (Applicant)
6th B - Low Blue 2nd Poom / Dan
5th B - HIgh Blue 3rd Poom / Dan
4th R - Low Red 4th Dan (For Minors)
3rd R - HIgh Red 5th Dan
Mobile Number of Parent or Guardian
(For PTA Examiner's Use Only)
Form 1 2 3 4 5
WAIVER
Self-Defense 1 2 3 4 5 1. I will abide by the rules and regulations of the PTA
for this promotion test.
Kicking 1 2 3 4 5 2. I hold myself responsible for any injuries that I may
sustain during the test.
Free Sparring 1 2 3 4 5 3. I shall uphold the code of sportsmanship and shall
avoid inflicting any intentional or malicious harm
Basic Movements 1 2 3 4 5 against my opponent during the test.
4. I hereby permit PTA to send SMS & E-mail to us
Behavior & Conduct 1 2 3 4 5 (Only for SMART, Talk N' Text, Red Mobile Subscribers)
Breaking 1 2 3 4 5
Applicant's Signature Over Printed Name
Decision
Name of Member:
Mobile Number:
Signature