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Kihon (100 Points: Must score 90 or above)
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Movement: (20 Points) Total Points _________
Tenshin Happo Tsuri Ashi 10 Points (5 Each side) _____
Tsuri Ashi 4 Points (2 Each side) ______
Tsugi Ashi 4 Points (2 Each side) ______
Chidori Ashi 2 Points (1 Each side) ______
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Stances (15 Points) Total Points _________
Zenkatsu Dachi 3 Points (1.5 Each Side) _____
Neko Ashi Dachi 3 Points (1.5 Each Side) _____
Shiko Dachi 3 Points (1,5 Each Side) _____
Han Zenkatsu Dachi 2 Points (1 Each Side) _____
Okutsu Dachi 2 Points (1 Each Side) _____
Sanchin Dachi 2 Points (1 Each Side) _____
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Blocks (10 Points) Total Points __________
Jodan Barai 2 Points (1 Each Side) _____
Chudan Barai 2 Points (1 Each Side) ______
Gedan Barai 2 Points (1 Each Side) ______
Soto Uke 2 Points (1 Each Side) ______
Nagashi 2 Poinst (Inside Each Waza) _______
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Punches/ Te Waza (10 Points) Total Points __________
Tsuki 2 Points (1 Each Side) ______
Shuto Uchi 2 Points (1 Each Side) ______
Tettsui 2 Points (1 Each Side) ______
Nukite 2 Points (1 Each Side) ______
Morote Uke 2 Points (1 Each Side) _______
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Kicks (10 Points) Total Points __________
Mae Geri 3 Points (1.5 Each Side) _______
Yoko Geri 3 Points (1.5 Each Side) ______
Mawashi Geri 2 Points (1 Each Side) ______
O-Mawashi Geri 2 Points (1 Each Side) ______
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Ido Waza (35 Points) Total Points __________
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Single Waza ( 26 Points) Total __________
Tsuri Ashi Oi Tsuki 4 Points (2 Each Side) ______
Tsuri Ashi Jodan Barai 4 Points (2 Each Side) ______
Tsugi Ashi Oi Tsuki 3 Points (1.5 Each Side) _______
Tsuri Ashi Mae Geri 3 Points (1.5 Each Side) _______
Tsugi Ashi Chudan Barai 3 Points (1.5 Each Side) ______
Neko Ashi Shuto Uchi 3 Points (1.5 Each Side) ______
Tsuri Ashi Gyaku Tsuki 3 Points (1.5 Each Side) ______
Tsugi Ashi Morote Uke 3 Points (1.5 Each Side) ______
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Multiple Techniques (9 Points) Total Points _________
Tsuri Ashi JB, Mae Geri, Gyaku Tsuki (3 Points) _______
Tsugi Ashi, CB, Gyaku Tsuki (3 Points) ________
Neko Ashi, Shuto Uchi, Tsugi Ashi Oi Tsuki (3 Points) _________
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Total: ____________ out of 100 Points
Kata
Taikyoku Shodan 10 Points __________
Pinan Shodan 15 Points __________
Shinsei 15 Points __________
Pinan Nidan 10 Points __________
Pinan Sandan 10 Points __________
Wankan/Shinpa/Juroku 15 Points __________
Pinan Yodan 10 Points ___________
Pinan Godan 15 Points ___________
Intermediate level, proficiency, especially in stances and movement, must be demonstrated in yellow and orange belt kata.
Application
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Yakusoku Kumite (performed at least twice, once slowly and once regular speed)
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Pinan Shodan Yakusoku
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Shinsei Yakusoku
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Sandan Gi
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Ippon Kumite
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10 Punches each side- Straight punch
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10 Punches each side- RH
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Self-Defense (w/ Shodan student, then test admin. or high level black belt)
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RH Punch
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Wrist Grab- same (all 3)
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Wrist Grab- opposite
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Lapel Grab- 1 hand
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Lapel Grab- 2 hand
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Bear Hug- Rear
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Frontal Choke
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Kick
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Tester’s Choice
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Applied self-defense
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Demonstrated ability against random technique executed by first a Shodan, then test administrator or higher level black belt
