AWA Dan Test Application

Complete the form below or download the form here.

I hereby apply to be considered for the rank of (select one)

Student Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Date of Birth

Nationality

AWA Member Number

IAF Number

Present Rank/Date Promoted/Exam Location

Aikikai Registration Number

Seminar/Camps/Nintei Kosu Attendance

Please include dates, locations, and hours attended.

Hours as Assistant Instructor

If promotion by recommendation, please provide additional information here.

Dojo Name

Dojo-Cho/Chief Instructor Name

Date

YYYY

Fees & Payments

Dan exam fees are:
Shodan $230
Nidan $255
Sandan $280.00
Yondan $355.00

Please make checks payable to:

Aikido World Alliance
Attn: Andrew Sato Shihan
4512 N. Lincoln Avenue
Chicago, IL 60625