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Enrollment Application
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Name
*
First
Last
Birthday
*
Mobile Phone
*
Email Address
*
INTERESTS & EXPERIENCE
Do you have any previous martial arts experience?
What sparked your interest in martial arts?
What do you do for work?
Tell us about your other interest and hobbies ...
How would you rate yourself in the following areas?
*Move each slider to the appropriate rating. Rating is as follows: 1- Strongly Disagree, 2- Disagree, 3- Neutral, 4- Agree, 5- Strongly Agree.
I have strong self-esteem.
Selected Value:
0
I am at a healthy weight.
Selected Value:
0
My stress level is low.
Selected Value:
0
I don't need to physically defend myself.
Selected Value:
0
I'm confident I could physically defend myself.
Selected Value:
0
I have great supportive friends.
Selected Value:
0
I am living a healthy lifestyle.
Selected Value:
0
GOALS & OBSTACLES
What benefits of martial arts training are most important to you?
Improved Self-Esteem
Weight Loss
Stress Relief
Self-Defense
Making Friends
Increased Fitness
Other
What are some of your goals? What would you like to accomplish through your training?
What do you think is your biggest obstacle preventing you from accomplishing your goal?
Is there anything else you think would hold you back?
Why do you think martial arts will be a good fit/ solution for you?
Is there any reason you couldn't attend classes 2x/week?
HOW DID YOU HEAR ABOUT US?
How long have you lived in the area? (Make a selection from dropdown menu.)
0 - 3 months
6 - 12 months
1 - 2 years
3 - 4 years
5+ years
Will you be living in the area for at least one year?
How did you hear about us?
Do you know anyone who trains here?
What are your top factors for choosing GFKA?
Quality of instruction
Personal attention given in class
Reputation
Curriculum
Location
Facility
Atmosphere
Other
GLENS FALLS KARATE ACADEMY STUDENT CREED
I intend to develop myself in a positive manner and avoid anything that would reduce my mental growth or my physical health. I intend to develop self-discipline in order to bring out the best in myself and in others. I intend to use what I learn in class constructively and defensively: to help myself and my fellow man and never to be abusive or offensive
Are you in good health and physical condition to begin a martial arts training program?
Are you willing to uphold the principles of our student creed, including enforcing the expectations within by holding yourself accountable to your actions?
Are you willing to commit time outside of class to practice what you've learned?
THANK YOU!
We greatly appreciate your interest in our programs at Glens Falls Karate Academy. Upon submitting your application, our admissions staff will review your survey and reach out to you with any further questions or next steps for setting up your first visit! Keep an eye on your email (the address provided earlier) for a confirmation that we've received your application as well as an outline of the remainder of our enrollment process.
If there is any other information you wish to provide, or questions you'd like to discuss when we call, please feel free to add them below:
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