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White Tiger Association APPLICATION FOR PROMOTION TEST
Name: __________________________________ DOB: _______________ Gender: F / M
Address: ________________________________________________________________
City: __________________________ State: ____ Zip: _____ Phone #: _____________
Email Address: ___________________________________________________________
Style of Martial Arts you are testing for___________________________________
Present Rank: ___ __________________________ Testing Rank: ___________________
Testing via Video ____ Testing in Person _______ Expected Test Date: ____________
Submitting your video and test fees does not guarantee your promotion to that rank. If you do not pass, an explanation of what you need to work on will be sent back to you along with your video. You will then need to resubmit a new video and test fees when you are ready to test again.
Students Signature ____________________________________________ Date__________________ Parent/Guardians Signature ______________________________________ Date ________________
Rank to be Awarded ____________________
Name of Examiner _____________________ Signature _____________________________
White Tiger Association APPLICATION FOR PROMOTION TEST
White Tiger Students
Test fees for White Tiger Kenpo Students are $10.00 to cover the cost of the test kit. Please remember that 3rd Brown and Black belt must be done in person. Please send $10.00 along with this application and we will mail you the testing kit so that you can test for your rank.
• The fee includes the following: o Belt Test Application Form o Testing Kit which includes the testing audio CD that will call off the techniques for you. o Free Certificate for successful promotions o A Critique of you test for future improvements o Listing of your promotion to our website.
Non White Tiger student may test for promotion via video tape when applying for promotion with the exception of 3rd Brown, 1st Black Belt, 3rd Brown and 1st Black and above you must test in person for these ranks. You may also test in the following styles as well:
• Kenpo (All styles of Kenpo)
• Goju
• Shotokan
• Combat Aiki Jujits
• Tae Kwon Do
• Pitbull Jujits
The test fees for rank for non members are as follows: Yellow - Purple $25.00
• Yellow – Purple $25.00
• Blue - Green $35.00
• 3rd Brown (in Person) $50.00
• 2nd and 1st Brown $50.00
• Black Belt (test in person) $100.00
• 2nd Black (test in person) $150.00
• 3rd Black (test in person) $200.00
White Tiger Association APPLICATION FOR PROMOTION TEST
Submitting your video and test fees does not guarantee your promotion to that rank. If you do not pass, an explanation of what you need to work on will be sent back to you along with your video. You will then need to resubmit a new video and test fees when you are ready to test again
Please note that if you choose to have Shihan Jim Rathbone fly to your school, you will need to pay for 2 airline tickets, food and lodging while there. There is a minimum of a two day stay.
Shihan Jim Rathbone Phone # 727-375-0761
Email: [email protected]
