New MAC Commissioner - Online Registration

Martial Arts Commission

New Commissioner Application
Date of Submission

MonthDayYearHourMinutesAM/PM Option
GENERAL INFORMATION
Full Name

First NameLast Name
Gender (M or F)
Birth Date

MonthDayYear
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Best Phone

Area CodePhone Number
Occupation (Choose as many as apply)
Job Title
Name of Martial Art School or NA
Number of Martial Art Students in my school?
Current Instructor's / Mentor's Full Name (or John Doe)

First NameLast Name
Current Instructor's Dan Rank
At this School, I am ... (Check all that apply)
School/OfficeAddress

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
School/Office Phone Number or 000-000-0000

Area CodePhone Number
FAX Number or 000-000-0000

Area CodePhone Number
Best Phone or 000-000-0000

Area CodePhone Number
Best E-mail
I look at my email
Website URL of NA
Dan Rank History
Date Began TKD/MA Training OR JANUARY 1, 1920)

MonthDayYear
Date Achieved 1st Dan (or JANUARY 1, 1920)

MonthDayYear
Date Achieved 2nd Dan (or JANUARY 1, 1920)

MonthDayYear
Date Achieved 3rd Dan (or JANUARY 1, 1920)

MonthDayYear
Date Achieved 4th Dan (or JANUARY 1, 1920)

MonthDayYear
Date Achieved 5th Dan (or JANUARY 1, 1920)

MonthDayYear
Date Achieved 6th Dan (or JANUARY 1, 1920)

MonthDayYear
Date Achieved 7th Dan (or JANUARY 1, 1920)

MonthDayYear
Date Achieved 8th Dan (or JANUARY 1, 1920)

MonthDayYear
Date Achieved 9th Dan (or JANUARY 1, 1920)

MonthDayYear
KUKKIWON CERTIFICATION
Your Present Kukkiwon Rank (or NA)
Dan Certificate # (or 0000)
Kukkiwon Certification Date (or JANUARY 1, 1920)

MonthDayYear
USAT-MAC DAN RANK CERTIFICATION
USAT-MAC Taekwondo Rank (or NA)
USAT-MAC Certificate # (or 0000)
USAT-MAC Certification Date (or JANUARY 1, 1920)

MonthDayYear
OTHER DAN RANK CERTIFICATION
Your Rank from other Organization (or NA)
Other Organization Certificate # (or 0000)
Other Organization Certificate Date (or JANUARY 1, 1920)

MonthDayYear
Name of Organization Issuing Your Certification (or NA)
RESUME
I would like to become a Commissioner
I am recommended by the this/these Commissioner(s)
By Experience and/or Education I am best qualified to serve the Martial Arts Commission by participating in the following Councils:
Council of 1st Choice
Council of 2nd Choice
Council of 3rd Choice
Council of 4th Choice
Names of Organizations you currently belong to (other than USAT)
Martial Arts Achievements / Experiences
Education and Achievement other than Taekwondo - Martial Arts (Highest Level of Education)
Community (Experiences / Services / Achievement)
Your plans and thoughts regarding the position(s) in which you would like to serve.
USAT MEMBERSHIP STATUS
My USAT Membership Status
I have been a USAT (formerly USTU) Member since
USAT Membership # or NA
I will register for USAT Membership
I am the owner of a currently registered USAT Club
Club Number or NA
Number of Registered USAT Members in my school?
I have had a registered USAT (formerly USTU) Club since ...
Upload your Personal Photo, Certificates and Resume (Martial Art Activities; Other Career; Community Service) These documents will be required to complete your application. If you cannot upload them now, please prepare to mail them as soon as possible.
Upload your Portrait Photo

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Upload a copy of your Highest Rank Certificate (Org #1)

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Upload a copy of your Highest Rank Certificate (Org #2)

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Upload a copy of your Highest Rank Certificate (Org #3

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Upload your Resume

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Would you like to recommend someone to be a Commissioner?
Recommended Person's Full Name

First NameLast Name
Recommended Person's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Recommended Person's Dan Rank if applicable
Rank/Profession
Phone Number

Area CodePhone Number
E-mail
Web (URL)
I am recommending this person because:
Enter the letters as shown. (If you make an error, another display will be shown)
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Upload your Personal Photo, Certificates and Resume (Martial Art Activities; Other Career; Community Service) These documents will be required to complete your application. If you cannot upload them now, please prepare to mail them as soon as possible.

Would you like to recommend someone to be a Commissioner?