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. 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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