段位申请表(示例)(共6页)

1、国技院晋段申请表Application for Promotion Test寸标准照张1 ID-size photoattach with paste国籍Nationality(Citizen)中国 住址Address中国北京Tel8718-2942e-mail姓名Name中文张怀斌出生日期Date of Birth年Year1991现有段位Current Grade 申请段位Dan/Poomapplied for1月Month4 段位号Dan Certificate No. 拼音 ZHANG HUAI BIN性别 Sex男 / 女M / F日Day10签发日期Date of Issue ()

2、 . 身份证号码 submit this application to the Promotion Board of KUKKIWON for a Promotion Test. 会员证号码： 申请日期 Date of application: 2007.10.22 申请人Applicant: 张怀斌 () .I honestly recommend the above person as a well-qualified applicant for the promotion test of Dan/Poom grades.国家country中国所属协

3、会Name of Association/Dojang 中国跆拳道协会（CTA）考核推荐人Recommended by金星辉协会地址Address of Association/DojangNo.2-3 Tiyuguan Road , 考核推荐人段位及段位号Recommenders Dan Certificate No or Date of Birth 09012236Chongwen District, Beijing, China 100061Tel/ Fax/ e-mail 8718- 2942 / 8718- 2932 / To: President KUKKIWON(World Ta

4、ekwondo Headquarters)NOTE1. Name : The name must be printed or typed.2. Dan Certificate No : The current Dan number must be the one given by Kukkiwon or WTF.3. Recommended by : The recommender of applicant should ensure that no false statement will be found in the application, otherwise, the Dan wil

5、l be nullified even after its issuance and recommender will not be allowed to make further recommendations.4. Applicant who staying abroad shall attach a document to confirm actual residence in the foreign country for more than 6 months.1. : 2. : .3. : , .4. 6 . Kukkiwon(March 01, 2006) 國技院樣式(2006.0

6、3.01) Application for Promotion Test 1 1 ID-size photoattach with paste Nationality(Citizen)CHINA AddressZHONG GUO HARBINTele-mail NameFirst Date of BirthYear ()Current Grade ()Dan/Poomapplied forMiddle Month () Dan Certificate No. Sex / / Last Day Date of Issue () . :ID Card NO:

7、I submit this application to the Promotion Board of KUKKIWON for a Promotion Test. :（Membership Card No） Date of application: Applicant () .I honestly recommend the above person as a well-qualified applicant for the promotion test of Dan/Poom grades.countryCHINA/ Name of Association/Dojang Chinese T

8、aekwondo Association Recommended by JIN XING HUI/ Address of Association/DojangNo.2-3 Tiyuguan Road , Recommenders Dan Certificate No or Date of Birth 09012236Chongwen District, Beijing, China 100061Tel/ Fax/ e-mail 8718- 2942 / 8718- 2932 / To: President KUKKIWON(World Taekwondo Headquarters)NOTE1.

9、 Name : The name must be printed or typed.2. Dan Certificate No : The current Dan number must be the one given by Kukkiwon or WTF.3. Recommended by : The recommender of applicant should ensure that no false statement will be found in the application, otherwise, the Dan will be nullified even after i

10、ts issuance and recommender will not be allowed to make further recommendations.4. Applicant who staying abroad shall attach a document to confirm actual residence in the foreign country for more than 6 months.1. : 2. : .3. : , .4. 6 . Kukkiwon(March 01, 2006) 國技院樣式(2006.03.01)备注：、 申段人员必须为中国跆拳道协会的个人会员，如果不是协会的个人会员请下载协会个人会员的申请表，并在会员注册