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SAFETY GEAR REQUIRMENTS White to Gold: Head Gear $32.95 Gold to Green: Chest Protection $34.95 Green to Purple: Foot and Hand
Gear $50.00 Purple: Complete AGE GROUP:
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FEE SCHEDULE Camo $30 White $30 Gold Belt $35 Green Belt $40 Purple Belt $45 Blue Belt $55 Red Belt $60 Brown Belt $65 JB $70 |
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LAST
NAME ________________________ |
FIRST NAME ____________________ |
|
ADDRESS
____________________________________________________________ |
|
|
CITY/TOWN _______________________ |
ZIP CODE _________________________ |
|
PHONE NO. ________________________ |
DATE OF BIRTH _____________________ |
|
AGE _____________________________ |
|
|
PRESENT RANK |
RANK GRADUATING TO |
BELT SIZE |
MONTH OF GRADUATION |
|
White Belt |
White Belt |
000 |
January |
|
Gold Belt |
Gold Belt |
00 |
February |
|
Green Belt |
Green Belt |
1 |
March |
|
Purple Belt |
Purple Belt |
2 |
April |
|
Blue Belt |
Blue Belt |
3 |
May |
|
Red Belt |
Red Belt |
4 |
June |
|
Brown Belt |
Brown Belt |
5 |
July |
|
Junior Black Belt |
Junior Black Belt |
6 |
August |
|
Black Belt |
Black Belt |
7 |
September |
|
1st Degree |
1st Degree |
|
October |
|
2nd Degree |
2nd Degree |
(this size is found on |
November |
|
3rd Degree |
3rd Degree |
the uniform tag) |
December |
|
Dear Student & Parents: Please take a moment to
read and fill out this application for graduation. Be sure to fill in all the
information blanks. This application is only to
be submitted to the front desk if the student is on the graduation list. Remember, it takes us time
to organize the graduation and order the supplies, so please hand in this
application in no later than one week prior to the graduation. |
GRADUATION CHECK LIST: 3 Stripes Test Fee Safety Gear Complete Patch Clean, White Uniform Student Signature _______________________ Parent Signature _______________________ |
