Date of the exam *
Location of the exam *
Which dan grade exam are you taking? * Shodan (1st dan)Nidan (2nd dan)Sandan (3rd dan)
Is the exam a retake? * NoYes
If it's a retake, please type in the date and location of the previous exam
First and Lastname *
Date of birth *
Age *
Street address *
Postal code *
City *
E-mail address *
Telephone *
Club *
Instructor/coach *
The year when you started training karate *
Current grade, date of issue, issued by and location *
The registration No. of current grade if it's a JKF Wadokai dan grade
Wadokai membership number, if you are a Wadokai member
I have checked and confirmed the above information to be correct