PART 1 - APPLICANT DETAILS. PART 2-ORGANISATION DETAILS. PART 3 - ATTENDANCE. Please tick relevant box. Seminar& IIC Fees. A discount of 10 euro on the Course fee applies for all RITA members. Same fees apply for Jnr/Snr.

ONLINE ITF INTERNATIONAL INSTRUCTOR COURSE & ITF INTERNATIONAL TECHNICAL SEMINAR Conducted by Grandmaster Francis Barrett IX Degree 17^th and 18^th October 2020, 9:00am to 5:00pm Conducted via Zoom and hosted by BlessingtonTaekwon-Do School APPLICATION FORM Please type or print clearly

PART 1 - APPLICANT DETAILS

Full Name:		Rank (Dan):
Postal Address:
	Date of Birth:
Nationality:	Phone:
E-mail Address:
ITF Booklet Number	ITF Cert. Number:

PART 2-ORGANISATION DETAILS

Name of Taekwon-Do School:
Instructors Name:
Association Name:

PART 3 - ATTENDANCE

Please tick relevant box

Seminar& IIC Fees

	FEE
I am a 6^thKupto 1^stKupand apply for the Saturday seminar only and enclose fee of	50 Euro*
I am a 1^st -3^rd Degree and apply for the full Seminar/Course and enclose fee of	120Euro*
I am 4^th – 6^th Degreeand apply for the full Seminar/Courseand enclose fee of	150 Euro*
I am 7^th – 8^th Degree and apply for the full Seminar/Course	--------

*A discount of 10 euro on the Course fee applies for all RITA members. Same fees apply for Jnr/Snr.

All payments in EURO must be lodged directlyto the RITA Bank Account and proof of lodgement submitted with application form. Bank Account Details are as follows:

o Bank Name: Permanent TSB

o Account Name: RITA No. 1 Account

o Sort code: 990624 account number: 28279895

o BIC: IPBSIE2D IBAN: IE76IPBS99062428279895

Bank Address:

PERMANENT TSB,
8, OLD BAWN ROAD,
TALLAGHT,
DUBLIN
D24 HK35
Receivers Address: 32, Alderwood Ave, Springfield, Tallaght D24 RWR 2
** Please note also that the full international seminar fees do not include ITF Seminar certificate, but participants on the full course will receive barcode for the ITF Membership booklet. If you wish to receive a certificate, an additional payment of 30 Euro should be included with your application.

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