Student Page original


Student First Name Student Last Name Birtdate Gender
Full Name (How you want it to appear on Diploma ex – John P. Smith) Facility
City State Zip
Phone Email Address How Did You Find Us?
Emergency Contact Name Emergency Phone
List any Medical Conditions
Please fill out information below if student is a minor.
Mother/Guardian First Name Mother/Guardian Last Name Mother/Guardian Phone (if different)
Father/Guardian First Name Father/Guardian Last Name Father/Guardian Phone (if different)

Online Exams – Required

  • Students must have the Pre-Karate or regular Karate textbooks in order to take the above tests. Answers are in the back of the books. Books must be purchased from your karate instructor.
  • Take the online test for the belt you are testing for – not the belt you currently have.
  • Make sure to click “Submit Results” once you receive a 100% on the test – otherwise your test will not be credited.
Red Book Pre-Karate (4-5 year olds)First Name:

Last Name:

Belt Rank:

Select TestWhite/YellowWhite/OrangeWhite/PurpleWhite/BlueWhite/GreenWhite/Brown


Blue Book Karate (6 years old thru adults)First Name:

Last Name:

Belt Rank:


Written Exams

Black Belt Exam Black Belt Exam

The black belt exam in an in class exam that must be completed before taking the practical portion of black belt test. Students are required to complete the exam in one and a half hours scoring 100%.

Download Practice Exam