Testing Form

DYNAMIC FIGHTING ARTS
Rank Testing Application
Individual Fee: $20.00 (includes Sash & Rank Certificate)

Testing for our Shaolin Video Level Requirements 1-6
OR Testing for our Kuntao Level Requirements 1-6 (5 & 6 not yet available)

Make checks payable to: David Seiwert

Please fill out the following Testing Application, print and
mail to: Dynamic FightingArts
P.O Box 531183
Cincinnati, Ohio 45253

Name:___________________________________________________________

Address:_________________________________________________________

City: ________________ State: _____ Zip: _____________

Age: _________

Occupation:______________________________________________________

Email address:____________________________________________________

Rank Testing for: ________________________________

Please accept my application for Individual Rank Testing in the Dynamic Fighting Arts Organization. I have enclosed my testing fee and certify that I have completed at least 30 hours of training for each level.

Applicant Signature___________________________Date_________________