USBBF Application For Rank Recognition Form

Application For Rank Recognition
Although you may have submitted much of this information previously - we ask that you fill the form out fully. Information may have changed.

Focus on your history. If you already have a bio/training resume you may submit that via email and note that in the form.

You must submit your current rank certificate along with at least one of your previous rank certificates.

This form may be printed out and submitted via email or mail.

We will contact you if we have any questions. Please allow 2 weeks for processing.
USBBF Member #
Name *

First Name Middle Name Last Name

Address: *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Date of Birth *

Month Day Year
Date Date Picker Icon
Age
E-mail *
Phone Number: *

Area Code Phone Number
Social Media
Allow USBBF to repost ?
Gender *
Felony Conviction? *
Instructors Full Name *
Are you still affiliated with your Instructor
Explain your last answer
Current Rank *
Training History - Systems, Ranks, Instructors *
Club or School Name and Full Address *
Member Of Martial Arts Organizations? Please List
The applicant acknowledges and agrees that they are not authorized to use the United States Black Belt Federation authority, name, or logo in any manner without permission from United States Black Belt Federation. The United States Black Belt Federation name and logos may not be used on any letterhead, certificates, logo’s or facsimile’s of logos and on uniforms, created or outsourced by the applicant school(s,) instructor(s), and student(s).
However, the member is allowed to wear the United States Black Belt Federation patch on their uniform. You are of course welcome to say your a member, share USBBF posts, all the things any member would do just dont make yourself out to be something your not. If you want to use the logo in your advertising - let us know and we'll work with you.
Agree?
By clicking the "Pay Now" button you are submiting your online application and will be re-directed to Paypal to submit your payment. Once we recieve your payment, we will begin processing your application.

Thank you!
USBBF Rank Recognition $ 45.00

USBBF Member Patch $ 10.00

Quantity

Total $ 0.00

The payment is ready! It will be completed once you submit the form.
Do not forget to submit a bio/training resume unless you detailed this in the application.

You must submit your current rank certificate along with at least one of your previous rank certificates.

This form may be printed out and submitted via email or mail. USBBF - P.O. Box 666 - Gardendale, Alabama 35071 info@usblackbeltfed.com
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