Black Belt Test Information Form

Black Belt Test Information Form

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International Uechi-Ryu Karate Federation

Please fill out and submit this Black Belt Testing Information for requirement reviews and approval by the International Black Belt Test Administrator and the President of IUKF.

Full Name *
Email *
Address *
City *
State *
Birthday * Teacher Name * Zip Code *
Phone *
Teacher’s e-mail address *
Current Rank* Last Promotion * Rank being Tested for *
Date of Test* Are you an IUKF member? *
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Black Belt Reg
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Note: The test administrator will confirm information with your teacher and also will determine if all IUKF test requirements have been met. You will receive a follow-up e-mail as soon as possible.

Thank you for your submission

George E. Mattson
President, IUKF