Belt examination application / Formulaire d'inscription pour l'examen de ceinture
Please complete the following application to be considered for the belt examination.

The belt grading will take place at:
Lieu/Location: Paris - CDFAS au
64 Rue des Bouquinvilles, 95600 Eaubonne

on July 06, 2019

Veuillez remplir le formulaire ci-dessous et payer les frais requis.
Please complete the form below and pay the appropriate required fees.

Notes: Late application may not be accepted.

Email address *
Nom complet / Your name *
(Firstname, Lastname)
Your answer
Sexe *
Required
Année de naissance / Birth year
Your answer
Votre ville, état, pays / Your City, State, Country *
Your answer
Numéro de téléphone / Telephone *
Your answer
Quel est votre niveau de ceinture actuel? / What is your current belt level?
Your answer
Quand avez-vous atteint le niveau de ceinture actuel? / When have you attained the current belt level?
Quel niveau de ceinture souhaitez-vous atteindre lors de l'examen de la ceinture? What belt level do you would like to attain at the belt examination?
S'il vous plaît remplir les exigences avant l'examen de la ceinture / Please complete the requirements for your level prior to the belt examination
Honoraires / Fees
Frais d'examen ceinture rouge/ Red belt examination fee: $50 Euros
Frais d'examen de ceinture jaune / Yellow belt examination fee: $30 Euros

S'il vous plaît effectuer le paiement via PayPal à "lienlacvovinam@gmail.com"
Please make payment via PayPal to "lienlacvovinam@gmail.com"

I respectfully request the Overseas Vovinam Việt Võ Đạo Masters Management Council’s board of assessment and testing to approve and allow me to participate in the belt examination and will accept the board's judgement of my qualifications. *
A copy of your responses will be emailed to the address you provided.
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