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.

Teacher's Name*
Teacher's Mobile Number*
Teacher's Email Address*
Dojo Address (where certificate will be sent)*
Dojo City*
Dojo ZIP Code
Applicant's Full Name*
Applicant's Date Of Birth*
Applicant's Email Address*
Applicant's Last Promotion*
Rank Being Tested For*
IUKF Registration # (if any)*
Applicant's Test Date*
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Please use this PayPal button to pay the test administration fee.

  • Test administration fee – $100

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
Founder, IUKF

Video Instructions for Payment