Membership application form

advertisement
i ARNIS
Rank &
Promotion
APPLICATION
FORM
DATE OF APPLICATION ________________
APPLICANT’S SIGNATURE ABOVE
APPLYING FOR WHAT RANK
Write below what Rank applying for
MEMBER SINCE (YYYY) _____________
CHOOSE AN ITEM.
iARNIS ID No. ____________________________
APPLICANT INFORMATION
Name: Click here to enter text.
LAST NAME
GIVEN NAME
MIDDLE NAME
Date of birth: MM/DD/YYYY
Gender: Choose an item.
Phone: Click here to enter text.
Nationality: Click here to enter text.
Religion: Click here to enter text.
Mobile: Click here to enter text.
Civil Status: Choose an item.
Occupation: Click here to enter text.
Email: Click here to enter text.
Complexion: Click here to enter text.
Color of eyes: Click here to enter text.
Weight: weight
Height: height
Current address: Click here to enter text.
City: Click here to enter text.
County/Province: Click here to enter text.
State/Region: Click here to enter text.
Country: Click here to enter text.
Continent: Choose an item.
Postal Code: Click here to enter text.
CLUB INFORMATION (CURRENT)
only one please
Current Club: Click here to enter text.
Club address: Click here to enter text.
Phone: Click here to enter text.
Position/Designation: Click here to enter text.
E-mail: Click here to enter text.
Web: Click here to enter text.
ARNIS BACKGROUND (CURRENT)
STYLE/SYSTEM: Click here to enter text.
Current Rank in System: Click here to enter text.
Name of Instructor/Guro/Master: Click here to enter text.
Started in this style/system: _____________
Intructor/Guro/Master who’s signature appears below certifies that the applicant is
his/her student and the information in this section appears true and correct.
Ended in this style/system: _____________
Contact No. of Instructor/Guro/Master:
Click here to enter text.
email of Instructor/Guro/Master:
_____________________________
Signature of Master/Instructor/Guro
Click here to enter text.
ARNIS BACKGROUND (OTHER 1)
STYLE/SYSTEM: Click here to enter text.
Current Rank in System: Click here to enter text.
Name of Instructor/Guro/Master: Click here to enter text.
Started in this style/system: _____________
Ended in this style/system: _____________
Intructor/Guro/Master who’s signature appears below certifies that the applicant is
his/her student and the information in this section appears true and correct.
Contact No. of Instructor/Guro/Master:
Click here to enter text.
email of Instructor/Guro/Master:
_____________________________
Signature of Master/Instructor/Guro
Click here to enter text.
1
ARNIS BACKGROUND (OTHER 2)
STYLE/SYSTEM: Click here to enter text.
Current Rank in System: Click here to enter text.
Name of Instructor/Guro/Master: Click here to enter text.
Started in this style/system: _____________
Intructor/Guro/Master who’s signature appears below certifies that the applicant is
his/her student and the information in this section appears true and correct.
Ended in this style/system: _____________
Contact No. of Instructor/Guro/Master:
Click here to enter text.
email of Instructor/Guro/Master:
_____________________________
Signature of Master/Instructor/Guro
Click here to enter text.
ARNIS BACKGROUND (OTHER 3)
STYLE/SYSTEM: Click here to enter text.
Current Rank in System: Click here to enter text.
Name of Instructor/Guro/Master: Click here to enter text.
Intructor/Guro/Master who’s signature appears below certifies that the applicant is
his/her student and the information in this section appears true and correct.
Started Arnis: _____________
Contact No. of Instructor/Guro/Master:
Click here to enter text.
email of Instructor/Guro/Master:
_____________________________
Signature of Master/Instructor/Guro
Click here to enter text.
iARNIS / ARPI Background
Have you taken: (Yes / No and Date)
iARNIS Fundamental Course: Choose an item.
Click here to enter a date.
iARNIS GURO Accreditation : Choose an item.
Click here to enter a date.
iARNIS Referee & Judges Accrediation: Choose
an item.
Click here to enter a date.
Do You have appointments / positions in iARNIS/ARPI. Please List Below
Description:
Year/s
Click here to enter text.
Click here to enter text.
Click here to enter text.
Click here to enter text.
Click here to enter text.
Click here to enter text.
Click here to enter text.
Click here to enter text.
Click here to enter text.
Click here to enter text.
ARNIS Tournament Background
Please submit photocopy of certificate
Tournament
Date (YYYY/MM/DD)
Classification (eg. Participant, coach, medalist, T.O.)
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
2
iARNIS/ARPI Seminars Attended
Please submit photocopy of certificate
Tournament
Date (YYYY/MM/DD)
Classification (eg. Participant, Resource Person, Instructor, etc)
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
Click here to enter text.
Click here to enter a date.
Choose an item.
OTHER MARTIAL ARTS
Description
Rank
Click here to enter text.
Click here to enter text.
Click here to enter text.
Click here to enter text.
Click here to enter text.
Click here to enter text.
Click here to enter text.
Click here to enter text.
Click here to enter text.
Click here to enter text.
NOTE/S TO THE COMMITTEE:
CLICK HERE TO ENTER TEXT.
AGREEMENT
I hereby certify that the above information is true and correct, and that I
shall abide by all the rules and regulations of Arnis Pederasyong
Internasyonal, Inc. (iARNIS)
& Arnis Philippines, Inc. (ARPI). Any
Information that is found to be untrue would be grounds for but not limited
to termination of this application as deemed by the Board of Directors.
Signature of Applicant
Sign above printed name
FOR MINORS (APPLICANTS 17 YEARS OLD AND UNDER)
With Consent and Approval
Signature of Parent/Legal Guardian
Sign above printed name
Relationship to Applicant:



Choose an item.
This form Must be Filled-Up completely and legibly. Signatures of applicant, club president and Sec. Gen are required for the processing of this
application. (when sending via e-mail, photo and signatures must be uploaded on to it for the validation of your application)
attach one government issued ID (driver’s license, passport, Tax ID, voter’s Id, or postal ID) for minors; school ID and NSO Birth Certificate.
Warning: processing fee shall be forfeited if any information and/or document/s submitted is found to be false.
RANK
White Belt
Yellow Belt
Green Belt
Blue Belt
Brown Belt
Black Belt 1st Degree
Black Belt 2nd Degree
Black Belt 3rd Degree
Black Belt 4th Degree
Black Belt 5th Degree
Black Belt 6th Degree
Black Belt 7th Degree
Black Belt 8th Degree
Black Belt 9th Degree
Black Belt 10th Degree
Description/Level
ENGLISH
FILIPINO
Novice
Intermediate 1
Intermediate 2
Intermediate 3
Advanced
Master 1
Master 2
Master 3
Master 4
Master 5
Senior Master 1
Senior Master 2
Senior Master 3
Senior Master 4
Grand Master
Baguhan
Sanay 1
Sanay 2
Sanay 3
Bihasa
Lakan/Lakambini Isa
Lakan/Lakambini Dalawa
Lakan/Lakambini Tatlo
Lakan/Lakambini Apat
Lakan/Lakambini Lima
Lakan/Lakambini Anim
Lakan/Lakambini Pito
Lakan/Lakambini Walo
Lakan/Lakambini Siyam
Lakan/Lakambini Sampu
3
Download