Coach/Officals Clinic Form - $35 Fee

(*) Indicates Required Field - Back to Main Forms Page

*First Name:		*Last Name:
*Address:		*City:
*State:		*Zip:
*Phone:		*Email Address :
*Date of Birth:		*Age:
*Gender:	Male Female	*AAU District :
*Current AAU Membership Number:		*County in Which You Reside:

*Have you taken an AAU coach/official clinic in the last 5 years?

YES NO (If NO, skip next line)

What is your classification?		What is your certificate number?
Do you train in martial arts?		If so, what rank(s) do you hold?

What forms do you study? (Check all that apply)

WTF ITF TSD/MDK

Indicate any AAU-TKD office(s) you currently hold.

Clicnic Administrator Regional Director District Sports Director

Date:	AAU District:	Tournament Director:

TAE KWON DO SCHOOL AFFILIATION:

*MA School :	*Instructor:	*School City / State:

Please indicate the clinic you will be attending.

Clinic Location: Clinic Date:

To complete this registration you will be required to pay $35 via PayPal or credit card through secure PayPal Checkout.