(Admissions and Records)
P.O. Box 281, Grand Blanc, MI 48480, USA
Telephone: (810) 232-6482

Shim Soo Do (1st Degree Black Belt Program)
Application For Admission

(Please Print Or Type)

Name:(Last)__________________________ First:_________________ M Initial:_____

Address(Street):____________________________________ City:_________________

State:__________ Zip Code:_________________ Country:_______________________

Date Of Birth: Month_____ Day_____ Year________ Phone: (______)______________

To be admitted to the Program you must hold the rank of at least 1st Degree Black Belt in a Martial Art issued by an organization recognized by the Institute. Tuition includes: Swordsmanship DVD Videos (White Belt to Black Belt), KMAF Certificate of Rank, KMAF Rank and Identification Card, and a Program Guide outlining the requirements you are to perform to reach the 1st degree black belt level in Shim Soo Do. There are no belts included with the program. To enroll in the Program, submit the following at this time:

  1. Admission Application and Fee: $75.00 (Countries other than U.S. add $50.00)
  2. Program Tuition Fee In Full $295.00 (Payable in U.S. Funds).
  3. A Photocopy of your current Certificate of Rank.
Tuition Fee and Admissions Fee must be paid in full when you submit this application. All Tuition and Fees are non-refundable. Submit payment in the form of a Money Order or Certified Check.

Check One:       ___ Money Order   ___ Certified Check

Once admitted to the Program you may submit video(s) of yourself performing the requirements for each rank when you are ready to test. Include the $25.00 Examination Fee each time you test for each Gup level, and the $115.00 Fee when testing for 1st Degree Black Belt. All fees are non-refundable and subject to change. Fees must be in U.S. Funds made payable to ITA. Mail all materials to:

Attn: Director of Admissions and Records
Post Office Box 281
Grand Blanc, Michigan 48480, U.S.A.

I hereby apply for admission to the Shim Soo Do 1st Degree Black Belt Program. I fully understand that there are no refunds for any tuition or fees. I certify that all information on this application and materials submitted are true and accurate to the best of my knowledge. I further certify that I am at least 18 years of age.

    ______________________________________     ___________________________
                                       Applicant's Signature                                                                   Date

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