Boxing Coach/ Corner Man/ Cut Man Application Form

"*" indicates required fields

Your Name*

First Name Last Name

Gender*

Date of Birth*

License Applied For*

Choose from drop down

Phone*

Email*

Your Home Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name of your Boxing Club*

Boxing Club Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Your coaching certifications*

Please upload your Coaching/ Cornerman/ Cutman Certifications (Image)

Max. file size: 4 MB.

NIS Regular/ NIS (6 WKS)/ Other Certifications

ID & Address Proof (Front)- Aadhar/ DL/ Passport*

Max. file size: 4 MB.

Any one of the Above

ID & Address Proof (Back) – Aadhar/ DL/ Passport*

Max. file size: 4 MB.

Any one of the Above

A Recent Photograph*

Accepted file types: jpg, png, pdf, Max. file size: 4 MB.