DH Dojo Grading Form

DH Dojo Grading Form

Dulwich Hill Kyokushin Karate Dojo (Grading Form)

153 Constitution Rd, Dulwich Hill, NSW 2203
Please Register Before the Grading
Student's Full Name

PrefixFirst NameLast Name
Student's Date Of Birth

DayMonthYear
Date

DayMonthYear
Date
Your Age on the Grading Day
Weight in KGS
Height in CMS
Address

Street Address

Street Address Line 2

SuburbState

Post Code
Mobile
Format: 0000 000 000.
Email
example@example.com
Your Current Grade:

My Products

Grading Fee Product Image

Grading Fee $50.00 AUD

Pick the belt Option for 10th, 8th, 6th, 4th & 2nd Upcoming Kyu Grade. Product Image

Pick the belt Option for 10th, 8th, 6th, 4th & 2nd Upcoming Kyu Grade.$20.00 AUD

BELT COLORS
Item subtotal:

Enter coupon

Total $0.00 AUD

Person Completing This Form's Full Name

First NameLast Name
Person Completing This Form's Signature
Payment Methods

Fastlane Checkout

Choose from one of the PayPal options to make your payment.

Contact Info

Payment Info
Should be Empty: