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Black / Poom Belt Application Form
段 / 品 證 申 請 表

***Please fill in the form below and submit to us on or before taking your Exam*
* 欄位請務必填寫正確資料。
Note: Fields with * mark are required to be filled.

*I apply for (tick as Appropriate):
Taekwondo / 跆拳道:
Hapkido / 合氣道:
Self-defence /自衛術:
Date of Joining:
*Membership number:
*Name :
中文名(If you have Chinese Name)
*Gender:
Male: Female:
*Date of Birth(e.g. 30/11/1980):
*HKID Card no.:
*Mobile Phone no.:
*E-mail address:
*Confirm E-mail address:
*Occupation:
*Nationality:
*Residential address:
*Applying Grade
*Current Grade:
*I am currently training in:
I want to buy a black belt uniform, my height is:
I have my own uniform.

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Notice:
注意:

1) The applicant's name and HKID number should be the same as the applicant’s HKID card number and name.
申請人的姓名及香港身份證號碼必須與申請人的香港身份證一致。
2)1 copy of HKID Card or Birth Certificate.
香港身份證或出生證明 副本一張。
3) To apply for second Dan/Poom or above, you have to submit a copy of your HKID card and first Dan or above certificate (Card type) together on to an A4 size paper.
如申請二段或以上,提交黑帶證書(卡)的副本一張。(與香港身份證/出生證明 副本於同一張紙上。)
4) 4 Passport sized Photos.
證件相 4張。

For non-Chinese Hong Kong (如非中國香港人士)

1)The applicant's name and HKID number, should be same the as the applicant's HKID card number and name.
申請人的姓名及身份證號碼必須與申請人的香港身份證一致。
2) 2 copies of Passport.
護照副本 2張。
3) To apply for second Dan/Poom or above, you have to submit a copy of your HKID card and first Dan or above certificate (Card type) together on to an A4 size paper.
如申請二段或以上,提交黑帶證書(卡)的副本一張。(與香港身份證/出生證明 副本於同一張紙上。)
4) 2 copies of HKID card or Birth Certificate.
香港身份證或出生證明 副本2張。
5) 4 Passport sized Photos.
證件相 4張。


Hong Kong Hapkido & Taekwondo Federation /香港合氣道及跆拳道聯盟
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