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

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

What is your name?

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* 2. What is your name?

What color is your current belt?

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* 3. What color is your current belt?

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

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

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

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* 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

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

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

What has been your biggest obstacle getting to your next belt?

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

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

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

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

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

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

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

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

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

List two ways you have changed – physically

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* 12. List two ways you have changed – physically

List two ways you have changed - mentally.

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

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

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

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

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

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

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* 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

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