American Martial Arts Academy – Simi Valley BELT Promotion Test Application

PARENT AND TEACHER APPROVAL

PARENT SECTION

Please complete the following:

 My Daughter / Son has been behaving and cooperating at home.

If “NO,” please explain:

 There is a reason that I would like AMAA to withhold promotion testing at this time.
If “YES,” please explain:

Request for the Best Evaluation

Behavior at Home O S N Chores/Listen to Parent(s) O S N

Respect towards Parents O S N Time Use / Homework O S N
Respect towards Others O S N Others/Specify O S N
Self Respect / Hygiene O S N Comments:

O = Outstanding S = Satisfactory N = Needs Improvement

TEACHER SECTION

Student Name: School:

Our main objective at American Martial Arts Academy is to develop well-rounded students. Our students must show the same respect,
discipline, humility, and compassion for others outside the AMAA studio as they do inside the studio. If our students do not meet the
following qualifications at school or at home, we will withhold the student's ranking until there has been satisfactory improvement.

Please complete the following:

 This student has been doing satisfactory school work and is receiving passing grades. Yes / No
 This student has been behaving in a respectful and disciplined manner at school. Yes / No

Teacher's Name: ____________________ Signature: ______________________ Date:__________

Teacher's Comments:
___________________________________________________________________________________

Phone Number:______________ Ext:________________ Email:_________________________

Would you be interested in having American Martial Arts Academy conduct an Anti-Bullying/Confidence workshop for your class or
school? Yes/No

Thank you for your cooperation

I pledge to recognize American Martial Arts Academy's instructor's as my guide in my Martial Arts development and that AMAA
is the sole representative for me in the Martial Art and sport of Tae Kwon Do.
▶ I am applying for a promotion test above. I am paying for an application fee and understand this fee is non-refundable.
▶ That the Association or Kwan and its members are not responsible for any accidents which may occur during the
promotion test.
▶ I will accept the rank given to me.

I pledge to support the rules and regulations of American Martial Arts Academy.

Signature of Applicant Date Signature of Parent or Guardian Date