Belt Examination Registration

GRADING

Official Exam

Kukkiwon

Examination Registration Form

Exam fee must be paid before Examination Day

01 — Candidate Information

Full Name *

Date of Birth *

Age

Gender

School / Club

Instructor

Parent / Guardian Name

Contact Phone *

03 — Grade Marks

Category	Grade	Remarks
Basic Hands
Basic Kicks
Poomsae
Knowledge
Self Defence
Free Sparring
Destruction (Hand)
Destruction (Foot)

Spirit in Training

Mark each class attended in the lead-up to examination (1–10)

Belt Awarded

Examiner Initials

Examiner Remarks

04 — Fee & Declaration

JMD

4,000

Examination Fee Includes belt fee. Must be paid before Examination Day.
Non-refundable once paid.

Payment Status

I hereby agree to obey all the rules and regulations of the Federation, and to accept the grade given to me by the examiner. I also understand that the exam fee is not refundable. I confirm that I am in good physical condition to participate in this examination.

Student Declaration: I agree to the above terms and accept the examiner's decision as final. Parent/Guardian Consent (if under 18): I consent to my child participating in this examination.

By submitting you confirm all information is accurate. Exam fee is due before examination day.

Registration Submitted!

Your examination registration has been received. Master Ken will confirm your slot and payment details via WhatsApp.

Reference Number

—

Exam Fee Due

JMD $4,000