Student Black Belt Application

Black Belts planning to test, please enter your information below.

Board Breaking Registration

* Date Added
* School Name
Student #		123
First Name		abc
Last Name		abc
* Testing Date
Age		123
Weight		123
* Rank at Testing
Right Hand Technique
Left Hand Technique
Right Foot Technique
Left Foot Technique
Power Breaking Technique
Power - # of Boards
Speed Breaking Technique
# of 6 inch boards used
# of 8 inch boards used
# of 10 inch boards used
# of 11 inch boards used
Didnotcomply		abc
Notes		abc
* ID (key)		123
* LastUpdate
R Hand bds broken
L Hand bds broken
R Foot bds broken
L Foot bds broken
Power break broken
Speed break broken
HandRAttempts
HandLAttempts
FootRAttempts
FootLAttempts
PowerAttempts
SpeedAttempts