EXAMINATION APPLICATION FORM
To the President of the ALL NIPPON KYUDO FEDERATION
Dan Required: Sandan Examination Place:__Spartanburg, South Carolina, USA
Shogo Required: ______ Date: __7_/_16_/20_06_
Surname Forename(s) Male Date of Birth
Smith Jane * _____42_____
Name in Japanese Female __1__/__18_/__64_ Age
Address: 422 Cloud Drive
Redwood City, CA 94303
Present ANKF Date Approved Date Renshi Title Approved
Grade: ___2__Dan _6_/_6_/_2004 ______/______/______
Academic Record: Occupation:
BS from San Jose State Marketing Vice President
Kyudo Career Seminar Attendance (last 3 years)
Year Month Record Year Month Seminars
1977 Apr 13 Began Kyudo in Tokyo, Japan, at 2003 July Attended Kyudo USA 2003 at
ABC dojo, under instruction of
Spartanburg, SC, USA.
Shinji Kimura, Kyoshi, 7 th dan.
2002 Sept 10 Began Kyudo study in America at
2004 June Attended Kyudo USA 2004 at
San Jose Kyudo Club under Indianapolis, IN, USA
instruction of David Smith, Renshi
2003 July 20 Shodan, Spartanburg, SC, USA.
2004 June 6 Nidan, Indianapolis, Indiana, USA
Currently studying with Susan
Heart, nidan, at the Berkeley
Signature of Applicant
Assessment of Candidate (To Be Completed by National President)
Details of Contribution:
National President: Signature:
NB. 1. Use original only and write in block letters. Copies not allowed
2. In the case of false information, the application will be disqualified Receipt
3. 1 year should have elapsed since passing the previous grade/title
4. Write age at the time of examination
5. Only international seminar attendance is required
Notes for the Sandan application:
Kyudo Career: This student has included the important points in her kyudo career such as when
and where she started studying kyudo in Japan, where and when she began kyudo study in
America, and who her current instructor is in addition to the dates and places she was awarded
her dan ranks.
And despite the limited space, she managed to get her seminar history on the test application
instead of having to include a separate sheet. Good job!
Signature of National President: Although it says “national” president, this space is for the
signature of the American federation president this candidate is affiliated with. The federation
president should sign his or her name and also write the federation name in this space.
NB. Although the notes ask the applicant to write in block letters, the ANKF office has confirmed
that using a typewriter or a word processor is acceptable also.
Not seen on the application: One of the most important things about this application is what you
don’t see; she has made a copy of it before turning it in to the federation president. That way
she’ll have a good working copy for reference when she fills out her next test application form and
won’t have to remember all the seminar dates, test ranks and everything else. And she is making
this copy for her own kyudo folder and not relying on her teacher to do it for her. Another good