American Karate Academies National Association
Individual Promotion Application and Payment Form
Person Applying
*
None
Sensei
Tashi
Renshi
Shihan
Kyoshi
Hanshi
Other
Title
First Name
Last Name
Contact Information
*
Phone Number (example: 123.123.1234)
Email (example: example@example.com)
Chartered Dojo of Person Applying
*
Name of Dojo
AKANA # (example: WA-002)
Person Recommending Promotion
*
Instructor
Board Member
Self
Other
Who is Applying?
Name/Title
Phone Number
Which of the promotion applications are you applying for?
Yudansha (Black Belt) Promotion - $100 for Shodan (Add $50 for each additional Dan)
Teaching Credential Title Certification (Sensei or Shihan) - $200
Honored Title Certification (Tashi, Renshi, Kyoshi, or Hanshi) - $200
Yudansha Rank Promotions
A student who is promoted to a Yudansha Rank that is recognized by AKANA will receive an 11x17 Black Belt certificate signed by O'Shihan Jerry Piddington and the AKANA Board of Directors. If the Black Belt is a member of an AKANA Chartered School, they must be promoted through their school. The Black Belt must be a current member of AKANA in good standing. Black Belt Promotions include Junior and Senior Black Belt ranks. Members of an AKANA Chartered School, the administrator of the AKANA Chartered School, or an AKANA Board Member can use this form to apply for AKANA Black Belt Promotions. If the student is an Individual Black Belt Member that belongs to a school that is not an AKANA Chartered School, the blessing of their instructor is required through a conversation with an AKANA Board Member, and must complete an Individual Black Belt Promotion Form. All High Dan (6th Dan & up) must be approved by the AKANA Board of Directors. Only active membership years count toward time-in for future Black Belt Promotions, Teaching Credentials, and Honored Titles. Please send a jpeg image of the recipient in full formal uniform. All AKANA Black Belts will be issued a certification number and be listed on the AKANA website.
Teaching Credential Title Certification
A Yudansha who is promoted to Teaching Credentials by AKANA will receive an 11x17 Teaching Credential certificate endorsed and signed by O'Shihan Jerry Piddington and the AKANA Board of Directors and will be recognized by AKANA as a licensed teacher with the title of Sensei or Shihan. They will also receive the respective patch. Sensei Teaching Credentials require the rank of at least 2nd Dan and Shihan Teaching Credentials require the rank of at least 5th Dan. All Yudansha being considered for Teaching Credentials must be a current member of AKANA in good standing who is currently teaching in an AKANA Chartered School. Only active membership years count toward time-in for future Teaching Credentials. A Sensei or Shihan may wear the appropriate belt signifying their Teaching Credential status. This form must be completed and submitted by an administrator of an AKANA Chartered School. AKANA Teaching Credentials also serve as a license for teachers from other schools and systems. An AKANA Teaching Credential is required for any instructor who teaches at an official AKANA seminar or training event. Please send a jpeg image of the recipient in full formal uniform. All licensed teachers of AKANA will be issued a teaching certification number and be listed with their picture on the AKANA website.
Honored Title Certification
A Yudansha who is promoted to an Honored Title by AKANA will receive an 11x17 Honored Title certificate endorsed and signed by O'Shihan Jerry Piddington and the AKANA Board of Directors and will be honored by AKANA as a Tashi, Renshi, Kyoshi, and Hanshi. Honored Titles have many privileges that are recognized in AKANA. For Honored Titles, recipients have to meet certain requirements set forth by the AKANA Bylaws, such as rank, age, instructor status, school ownership, teachers of teachers, heads of styles, founder of styles, and head of organizations. All Yudansha being considered for Honored Titles must be a current member of AKANA in good standing who is active and contributing to the martial arts. Yudansha who receive an Honored Title may wear the appropriate belt signifying their title. This form must be completed and submitted by an administrator of an AKANA Chartered School or AKANA Board Member. Please send a jpeg image of the recipient in full formal uniform. All Honored Titles of AKANA will be issued a certification number and be listed with their picture on the AKANA website.
Person Receiving Promotion
*
Exact Name that will be on Certificate
Address the Certificate will be Mailed
City
State / Province
Postal / Zip Code
Personal Information
Date of Birth (example: 04/13/1959)
Age
Titles and Promotions
Please complete the information below for which title and what rank you are applying
Complete if Applying for a Rank Promotion
Prefix (example: Junior)
Belt Color (example: Black)
Dan or Kyu (example: 6th Dan)
Complete if Applying for a Teaching Credential
Sensei or Shihan
Dan of Black Belt (example: 7th Dan)
Years of Teaching
Complete If Applying for an Honored Title
Tashi, Renshi, Kyoshi, or Hanshi
Dan of Black Belt (example: 7th Dan)
Years of Serving/Contributing
AKANA Accomplishments
None
Bronze (2)
Silver (5)
Silver Diamond (7)
Gold (10)
Gold Diamond (17)
Pinnacle
Tomoe Warrior Status if Applicable
Kobudo Warrior Status if Applicable
Number of Sun & Moon Tests
Include Short Bio of Person Being Promoted
Such as Dojo, System of Study, Instructors, Titles, Year of Last Promotion, and Martial Art Accomplishments
Include Pictures
Browse Files
Drag and drop files here
Choose a file
Add a jpeg image of the last Certificate of Rank, Picture in Full Uniform for Certificate, Website, and Directory
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of
Signature
Approval Process
Once the application is processed, certificates and patches will be mailed within 3-5 business days. Thank you for applying.
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Yudansha (Black Belt) Rank
This price is for students who are not a member of an AKANA chartered school. If you are an AKANA member under an AKANA Chartered School, Go to Charter Promotion Application.
$
100.00
Junior Shodan (under 16 years old)
Junior Nidan (under 16 years old)
Junior Sandan (under 16 years old)
Shodan (16 years old and over)
Nidan (18 years old and over)
Sandan
Yondan
Godan
Rokudan
Shichidan
Hachidan
Kudan
Item subtotal:
$
0.00
Teaching Credentials
Students must be at least 2nd Dan for Sensei and 5th Dan for Shihan
$
200.00
Sensei
Shihan
Item subtotal:
$
0.00
Honored Titles
Tashi, Renshi, Kyoshi, and Hanshi
$
200.00
Tashi
Renshi
Kyoshi
Hanshi
Additional Certificates
$
25.00
Quantity
1
2
3
Item subtotal:
$
0.00
Payment Methods
Debit or Credit Card
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the form.
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