DE LHI TAEK W ONDO ASSOCIATION(R )

AFFILIATED TO DELHI OLYMPIC ASSOCIATION

IDENTITY CARDFORM COLOUR PHOTO

PersonalDetails
NameofAthlete: _

DateofBirth: _Gender:_ _

NameofParent/Guardian: _ _

EmailAddress:

ContactNo: _

PermanentAddress: _

Academy Name :
----------------------------------

CoachName:

_District.

_BeltGradeColour/Bl

ack(ifBlackBeltmentionKukkiwonno):_ __ _

1. Application form is common to all seeking registration with Delhi Taekwondo Association (DTA) under various category i.e
Colour Belt & Black Belt.
2. For change of permanent Address / Transfer to District/Club shall give NOC from concern Coach/Club/District.
3. If a student is found having more then one id card or has submitted wrong date of Birth, he/she will be suspended for 6 th Month.
4. Duplicate card and Re-issue fee is Rs.250/-
5. All coloum must be filled in capital letter (English).
6. This card can used only for Delhi Taekwondo Association activities.
7. Applicant/student must submit his/her self-attested copy of Aadhar Card/License/Passport with the application form.

SignatureofParent/Guardian SignatureofAthlete SignatureofCoach

621,POCKET-3,PASCHIMPURl,N E WDELH l-110063

EMAIL:·har sh_tkd_india@yahoo.co.in WEBSITE:-www.dtaindla.or g