Blue Wave Winter Camp 2018: Testing Candidate Information
Please fill out this form ONLY if you intend to test at Blue Wave Winter Camp, March 9th, 2018. Please speak with your instructor about paying testing fees.

Your name will appear on your Black Belt Certifications as it is entered here. Email gwhite@bluewavetkd.com with any issues. Photos will be taken at testing.

First Name *
Your answer
Middle Initial
Blank is OK
Your answer
Last Name *
Your answer
Gender *
M or F
Your answer
Month Date of Birth *
for example "July"
Your answer
Day - Date of Birth *
"19"
Your answer
Year Date of Birth *
"1988"
Your answer
Uniform Size - (instructors *may need this info) *
Belt Size *
Street Mailing Address *
Your answer
City or Town *
Your answer
State *
Your answer
Zip Code *
Your answer
Current Rank *
Testing for the Rank of *
Kukkiwon Cert Number *
type N/A if testing for 1st Dan
Your answer
Current Chung Do Kwan Dan number *
type N/A if testing for 1st Dan or you do nont have one
Your answer
Blue Wave Dojang Location *
for example - Bradford
Email Adress *
Your answer
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