Officials 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 offices) you currently hold.

Clinic 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:

NOTE: To complete this registration you will be required to pay $35 via PayPal or credit card through the secure PayPal Checkout on the next page. When clicking on the button below, your registration information will be sent to the Tournament Registrar. However, your Registration will not be considered complete until payment has been made through PayPal.

YOU WILL NOT RECEIVE AN AUTOMATIC CONFIRMATION SO PLEASE DO NOT REGISTER MORE THAN ONCE! YOU WILL GET AN EMAIL FROM AKA WHEN YOUR APPLICATION AND PAYMENT HAVE BEEN RECEIVED.

If you do not receive an email from AKA within 24 business hours of submitting and paying, please call Katherine or Kathy at 281-492-2411 to check your status.

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