National Commission of Traditional Martial Arts

Application for (Please check one that you are applying for):

Please specify which art(s) you are applying:

1. ____Martial Arts Education Certification (NCTMA)

2. ____Fundamentals of Martial Arts Certification (NCTMA)

3. ____Eastern Way of Health Certification (NCTMA)

4. ____The Way of Tea Certification (NCTMA)

5. ____Art of Yeum Yang and Five Elements Certification (NCTMA)

6. ____Ancient Art of Ki Certification (NCTMA)

7. ____Rescue Methods Certification (NCTMA)

8. ____Natural Healing Art Certification (NCTMA)

9. ____Vital Spots Certification (NCTMA)

10. ____Art of Baduk Certification (NCTMA)

11. ____Diplomat in Traditional Martial Arts

If you have any following degrees:

Tae Kwon Do        Hap Ki Do        Moo Sa Sool         Soo Bak Ki   
Shaolin Chuan        Tai Chi Chuan        Wu Shu   

 

All Applicants must fulfill the following requirements:

• No Criminal Conduct or Immoral Behavior

• No Drug or Alcohol Abuse

Instructor Information (if applicable)

Applicant's Name:     Degree (if any):
Name of School:
Address:
Telephone:      Fax:
E-mail:

Master's Information (if any)

Master's Name: Degree: Root:
Name of School:
Address:
Telephone: Fax:
E-mail:

Personal Information

Name:
Address:
Telephone (Office): Fax:
Telephone (Home): E-mail:
 

Occupation:
Position:
Name of Business:
Address:

Married Single Widowed Divorced/Separated # Children

Physical Record

Height: Weight: Color Hair: Color Eyes:

Education

High School:
College:
Degree: 2 year 4 year Master's Doctoral Other

1. Have you ever been convicted of a felony or crime involving moral turpitude?
Yes No
Explain:

2. Have you within the past three years had, or currently have any mental illness, drug or dependency problem?
Yes No
Explain:

APPLICANT'S OATH

I hereby solemnly certify, under oath, that I am the person named in this application, that all statements I have made, and that the information contained herein is true.

I acknowledge that I have read all the information provided to me as an applicant, and I understand that the fee I am submitting is not refundable.

I hereby release, discharge, and exonerate the National Commission for Certification of Traditional Martial Arts and National Commission of Traditional Martial Arts , and their agents or representatives, and any person furnishing information, from any and all liability of every nature and kind arising out of the furnishing or inspection of such documents, records, or other information, in the investigations made by the National Commission for Certification of Traditional Martial Arts and National Commission of Traditional Martial Arts.

I certify that no prosecution is currently pending against me in any court in the United States or in any foreign country..

       I recognize that belts are awarded only when specific standards of performance can be met by the student during testing.  In the event that I may not perform to the satisfaction of the testing officials, promotion may be delayed until further progress has been demonstrated, after a designated period of further practice.  If I do not achieve the desired rank, I may test again for that rank at the next testing session.  I recognize that promotion standards are uniform and that each belt reflects a specific level of competence.  If he or she nominated outstanding in the             promotion test, the student can double test on the next upcoming test to move up another rank at the same time.  Whoever has the ability may take the advantage to double promote.

       I understand in the nature of Martial Arts in combative activities accidents may occur which may cause injury.

      Therefore I, above student, do hereby for myself, my heirs, executors, administrators and assigns, waive, release and forever discharge any and all rights and claims whatsoever for damages which I may have, or shall hereinafter occur to me, against my martial arts school, master, instructor or to other members, for any and all damages which may be sustained and suffered by me in connection  with my association or entry in any practice, class, performing in promotion test, or which may arise out of my travelling to, participating in or returning from such endeavour.

 

 

I authorize investigation of all statements contained in this application.  I understand that misrepresentation of facts calls for immediate dismissal.  By entering your name below your are submitting your authorized signature.

Signature:

Date:

 

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Please enter your comments here.

 

 

Please Submit Completed Registration Form With Payment Information or Print Completed Form and Mail to NCTMA With Registration Payment.

Do Not Fill In Any Information Below This Line

Approved By: Date:
Record No:  

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Thank you for your application. If you have any further questions, please feel free to contact us by email or by phone: