Victory Taekwondo

Graduation Application for White Belt to Yellow Belt

Name: 		 Class (circle one): Little Eagle      Children       Adult 
Graduation Time 		Graduation Date 	

Attendance Rating		

The test fee is non-refundable, I must agree to abide by the judge's decision in 
awarding or withholding promotion. I understand that failure to follow school 	
rules or remain a member in good standing may result in revocation of belt rank. 
Initial: 

Test Fee: $55 due 2 days before test
Additional: $10 Late Fee if after deadline
Make-up Testing: $65

Early Registration: $55

due 2 days before 

Date Paid 

Employee 

Method of 
payment 

Testing 
Fee 

Additional: $10 	Late Fee if after deadline 

Make-up Testing fee: 

Curriculum 
Kam Sa hyung 
Ten Basic motions 

$65 

A

B

C

D

Notes 

Keebon1/ Taegeuk 1/2 
Basic Kicking 
Ki Hap 
Confidence 
Questions 
Breaking 

Physical Test: 
Sit Up: 
Push Up: 
Flexibility: 

Progress Meeting: 

Master/Examiner: 

Pass/Retest 

Form Due At Least TWO Days
Before Testing

 

Graduation Application for White Belt to Yellow Belt 

Name: 	Age: 

As part of the testing procedure you must complete a one (1) page essay. The essay should 
be typed on a separate sheet of paper and stapled to the upper left hand corner. The essay 
should be handed in by the testing deadline. Please make sure to include your name, cur- 
rent belt level, and age on the top of the essay. 

Essay Questions: 
1. Define the meaning of respect. 
2. Why is respect so important in TaeKwonDo? 
3. How can we earn respect from others? 

Please rate the following questions from very little (1) to quite a lot (5) 

How much of a positive influence has TKD had on your life? 	1	2	3	4	5
How much has TKD helped you outside of TKD class? 	1	2	3	4	5
How much do you think TKD has made you a better person? 	1	2	3	4	5

Please rate the following questions from not often at all (1) to all the time (5) 

How often do you do acts of kindness for others? 	1	2	3	4	5
How often do you take time for yourself? 	1	2	3	4	5
How often do you practice TKD outside of TKD class? 	1	2	3	4	5
How often do you eat healthy meals? 	1	2	3	4	5

Please answer the following: 

How many glasses of water do you drink per day? 
How many servings of fruit to you eat per day? 	Vegetables? 
How many hours of exercise do you do per week? 
How many hours of community service do you do per month? 

How many pages have you read since you started Taekwondo?  +1000 or -1000