Please send this form to the WT education department (Fax to +82 2 553 4728) or E-mail to () by no than October 15, 2018 Please Attach your Application for the WT IR Seminar (THA) Photo here Name Last Name: (Family) Name: Residence Gender M( ) / F ( ) Where you belongs to: (MNA) Nationality Date of Birth (MM/DD/YEAR) Occupation Date of Issue Kukkiwon Dan (MM/DD/YEAR) Kukkiwon Dan Certificate No. National Referee Date of Issue Certificate No. (MM/DD/YEAR) (for Kyorugi Only) ( ) Mobile Number E-mail Valuable For International Shipping Shipping Address (English ONLY) Recommendation by Name: Signature: Member National Association President I hereby submit my application to attend the: The 109th International Kyorugi Referee Seminar to be conducted by WT. Date: Signature:
Please send this form to the WT education department (Fax to +82 2 553 4728) or E-mail to () by no than October 15, 2018 Application for the WT IR Seminar (THA) Please Attach your Photo here Name Last Name: (Family) Name: Residence (MNA) Where you belongs to: Gender M( ) / F ( ) Nationality Date of Birth (MM/DD/YEAR) Occupation Kukkiwon Dan Date of Issue (MM/DD/YEAR) Kukkiwon Dan Certificate No. National Referee Certificate No. (for Kyorugi Only) Date of Issue (MM/DD/YEAR) Mobile Number ( ) E-mail Valuable Shipping Address For International Shipping (English ONLY) Recommendation by Member National Association President Name: Signature: I hereby submit my application to attend the: The 109th International Kyorugi Referee Seminar to be conducted by WT. Date: Signature:
1.-Application-form-for-the-WT-IR-Seminar-Kyorugi-THA1.docx