International Taekwon-Do Federation I.T.F. 국제태권도련맹 Draugasse 3, 1210 Vienna, AUSTRIA Tel. (+43-1) 292 84 67 Fax (+43-1) 292 55 09 E-mail: director-af@itfhq.org secretary-gen@itfhq.org Website: www.itftkd.org PERSONAL DETAILS FOR MASTER PROMOTION Forename: Surname: Mr. / Ms. Birth place (city, country): photo Date of birth: Nationality: Dan applied for: Current Dan No. Date of last grading: Plaque No. last plaque renewal date: ITF-booklet No. Address: Website: E-mail: Education (School/ College/ University, place, period): 1. 2. 3. Occupation 1. Current: (period /country) 2. Previous: Qualification 1. (Job oriented, where & when) 2. Hobbies: 3. Previous: 3. (date) place (town) (applicant s signature) 1
ACTIVITY REPORT FOR MASTER PROMOTION 1. Social services rendered (only with official public authority or organization recognition): 1) 2) 2. Contribution to ITF (International-, continental-, national-, regional level): 1) 2) 3. Training history (from enrollment to present): (instructor s name) (dojang name) (plaque nr.) (town) from-to (yyyy to yyyy) 4. ITF Dan promotion details: 1 st Dan: 2 nd Dan: 3 rd Dan: 4 th Dan: 5 th Dan: 6 th Dan: 7 th Dan: 8 th Dan: 9 th Dan: (Dan cert no.) ( year) (town) (instructor) (examiner) 2
5. ITF qualifications: Umpire B: Umpire A: Int l Instructor: (Cert no.) (year) (town) (examiner) 6. Your ITF recognition plaque registrations and its renewal: (dojang name) (plaque nr.) (1 st reg. year) place (town) date (mm,yyyy) renewed latest 7. ITF endorsed International course/ seminar/ Intensive special training : (in the last 10 years) (seminar no.) (conductor) place (town, country) from-to (yyyy to yyyy) 8. Position held (ITF HQ, ITF Continental, ITF National Organization) : (position held) ( organization name) from-to (yyyy to yyyy) 9. ITF Awards received: 3
(name) (award occasion) (place, country) (award year) 10. ITF Championships (World-, Continental-, National-, Regional-/ Medal/ Cup) : (tournament title) (participated as) (country) (achievement) (year) 11. ITF participation (Congress, Continental-, National-, Regional meetings & eventsin the last 5 years): (event title) (attended as) (town, country) (year venue) 12. Applicant s students details: a) Student achievements in ITF World- / Continental Championship (tournament title) (country) (student name) (category/ div.) (placing) (year) 4
b) Number of currently active students (Gup holder) (1 st to 3 rd Dan) (4 th Dan) (5 th Dan) ( 6 th Dan) (umpire B) (umpire A) (instructor) Instructors name: Umpire (A Class) name: c) Number of applicant s students Dan applications in the last 3 years: (1 st Dan) (2 nd Dan) (3 rd Dan) (4 th Dan) ( 5 th Dan) (6 th Dan) (7 th Dan) (Int l umpire) (instructor) 13. Writings/ Publications on Taekwon-Do and other subject areas (type) (title) (pages) (year) (printing house) 14. Conduct of ITF International Seminar: (organizer) (sort of seminar) place (town, country) from-to (yyyy to yyyy) 15. ITF Taekwon-Do teachings in foreign country: (NGB representative name) place (town, country) from-to (yyyy to yyyy) 5
16. Others if any: 17. Photos (in attachment by Email): 1) 5 or more ITF-activity related photos that applicant deems very valuable 2) 5 or more group photos taken in recent 3 years in Dobok with ITF-students in Dojang. Photos submitted may be posted in ITF-website when considered necessary. Each photo should contain caption and date. 18. Brief personal message from applicant to ITF members if any: 19. Personal comments or opinions toward the ITF if any: =========================================================================== I have submitted these forms by email: 1. This completed Master promotion application form in word format, without signatures and NGB stamp. 2. A scanned copy of this Master promotion application form with all signatures and NGB stamp. (date) place (town, country) (applicant s signature) =========================================================================== (NGB name) (NGB Secretary General name) (signature) (NGB Representative name) (signature) Date: place (town, country): (NGB stamp) 6
=========================================================================== (ITF use only) ITF HQ and ITF Promotion & Commendation Committee Remarks Approved: Disapproved: Remarks: ITF Promotion & Commendation Committee Chairman signature ITF-President signature Date: Place (town, country): (ITF Stamp) Notes: Applicant may expand or minimize every area for writing if required. 7