* 1. Promotion night is Thursday, August 20th at 7:00pm. Please indicate if you will be attending.

* 2. What is your name?

* 3. What color is your current belt?

* 4. How are you contributing to the Action community? (teaching kids, sponsor family, encouraging others, etc.)

* 5. Would you like to learn more about helping the Action Leader in Training (LIT) team? If yes, please indicate why you would like to help

* 6. Think back to why you originally enrolled at Action . Why are you here now?

* 7. What has been your biggest obstacle getting to your next belt?

* 8. How could we have helped you more in overcoming this obstacle?

* 9. In what ways has attending Action Karate helped you at work or school?

* 10. In what ways has attending Action Karate helped you at home?

* 11. In what ways has attending Action Karate helped you as a parent (or as a child)?

* 12. List two ways you have changed – physically

* 13. List two ways you have changed - mentally.

* 14. List 5 Goals that you wish to work on within the next 3 months:

* 15. Brown/Red Belts you will need a weapon for class, see Mr. Ogborn for details.

* 16. Please rank on a scale of one to five (with five being the highest) the following:

  One Two Three Four Five N/A
Fun Atmosphere
Ease of Learning
Quality of Classes
Drills
Teaching Stlye
Cleanliness of Studio
Courtesy of Staff and Instructors

T