International TaeKwon-Do Association
P.O. Box 281, Grand Blanc, MI 48480, USA
Telephone: (810) 232-6482
Head Instructor Application
(Please Print Or Type)
Name:(Last)___________________________ First:___________________ M Initial:______
First Year Head Instructor Fee: $55.00
State:____________ Zip Code:___________________ Country:________________________
Date Of Birth: Month______ Day______ Year_________ Phone: (_______)______________
Instructor's Name:________________________________ Instructor's Rank:______________
Your Present Rank:______________ Date Of Rank: Month______ Day_____ Year:________
How Many Gups At This School?__________ How Many Dans At This School?__________
I, the undersigned, do hereby apply for Head Instructor status in the ITA
(International TaeKwon-Do Association). I agree to adhere to all the
rules and regulations which govern this organization and to follow the
policies and procedures set forth in the ITA Constitution and By-Laws and
by the Board of Directors and the President.
I am registering my School and all of my students, at this time, with the ITA and
registering all those who teach at my School, as Instructors, with the ITA.
I understand that under no circumstances will I be permitted to issue
and/or have printed, any type of certificate or card, of rank. I further
understand that all ITA Individual Applications for Membership and
promotions must be presented to ITA International Headquarters and must
be signed by the President and bear the ITA Official Seal.
In consideration thereof, I hereby agree that should I fail to abide by
the ITA's policies, procedures, and regulations, I may be dismissed and
that I shall not be entitled to a refund of any kind. I understand that
all payments of any kind are non-refundable.
Applicant's Signature Date
(Annual Head Instructor Renewal Fee: $35.00)
Submit: This Application And Fee, A Photo-Copy Of Your
Certificate Of Rank,
School Membership Application And Fee,
Individual Applications For Membership, For You and ALL Of Your Students
And The Fees As Indicated On The Applications.
Make All Fees Payable To ITA, In U.S. Currency.
ITA Membership Information