| | seminar / camp in accordance with WAKO Rules |
| 1. GENERAL INFORMATION: | | Approved |
| Name of seminar / camp: | | |
| Date of seminar / camp: | | |
| Place of seminar / camp: | | |
| Country of seminar / camp: | | |
| Organizer / promotor of seminar / camp: | | |
| National kickboxing federation: | | |
| 2. SEMINAR | | Approved |
| Name of seminar / camp: | | |
| Seminar topic: | | |
| Seminar type: | Licenced £ Educational £ | |
| Participants: | | |
| Duration of the seminar: | | |
| Web page (if any): | | |
| 3. PROGRAM | | Approved |
| Detailed program of seminar / schedule of camp: | YES £ NO £ | |
| Lecturer(s) / Instructor(s): | | |
| Literature / presentation attached: | YES £ NO £ | |
| Knowledge test attached: | YES £ NO £ | |
| Diploma / certificate attached: | YES £ NO £ | |
| Brochure of seminar / camp in attachment (if any): | YES £ NO £ | |
| Poster of seminar / camp in attachment (if any): | YES £ NO £ | |
| 4. OFFICIALS | | Approved |
| Organizer of seminar / camp: | | |
| Consent of the national federation | YES £ NO £ | |
| 5. FEE and CALENDAR | | Approved |
| _____€ sanctioning fee paid | YES £ NO £ | |
| Included in the WAKO calendar | YES £ NO £ | |
| Published on the WAKO web page | YES £ NO £ | |
| Name: | | | | | |
| Date: | | | | | |
| Sign: | | | | | |