Adult Grading form — Takemusu Aikido Canterbury

Name

First Name

Last Name

Date

date of your test

MM

DD

YYYY

Current Kyu or Dan Grade

if this is your first grading just put 'none'

New grade applying for

if you're unsure leave blank

Number of classes since last grading

I have made a payment of $25.00

Bank account 03-1592-0435992-00