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Personal Information
Height Weight Age

5’" – 5’5"

5’6" – 5’10"

5’11" – 6’2"

6’2"+

Under 150 lbs

150 – 170lbs

171 – 190lbs

191 – 210lbs

211 – 225lbs

225+

Under 18

18-25

26-30

31-40

41-50

Older then dirt
Build: Location Activity Level

Freakishly Strong

Bodybuilder

Athletic

20-40lbs overweight

40-60lbs overweight

Fat Boy Division

Quiet Suburbia

Close to the Action

Living in the City

Hard Living Area

I get shot at every night

Exercise Daily

Weekend Warrior

Every now and then

What is a dumbbell?
Career: Social Habits

Military

Police

Fireman

EMT

Security

Manual Labor

None of above
Smoker?
Yes

No
Frequent drinker?
Yes

No
Frequent drug user?
Yes

No
Frequent night clubs?
Yes

No
Frequent parties?
Yes

No
Do your friends fight?
Yes

No
Real Fighting Experience
How you been in a real fight before?
Yes

No
Have you ever faced a knife in a fight?
Yes

No
Have you faced a gun in a fight?
Yes

No
Have you faced club type weapon?
Yes

No
Have you faced multiple attackers?
Yes

No
Have you ever competed in a boxing or kickboxing fight?
Yes

No
Have you ever competed in a grappling tournament?
Yes

No
Have you ever competed in a MMA fight?
Yes

No
Martial Arts Training Level
  Many Years Some Training Just Started No Experience. pixel Are you interested in learning?
Striking Martial Arts
(Karate)
Yes
Grappling Martial Arts
(Judo, Jiu-Jitsu)
Yes
Mixed Martial Arts Yes
Reality Defense Training
(Krav Maga)
Yes
Other Yes
Self Defense Training
Trained in hand to hand combat?
Yes

No
Trained in knife defense?
Yes

No
Trained in club type weapon defense?
Yes

No
Trained in gun defense?
Yes

No
Trained to face multiple attackers?
Yes

No
Trained standing grappling?
Yes

No
Trained ground grappling?
Yes

No
Trained self-defense striking?
Yes

No
Contact Sports Experience Level
  Champion Avid Competitor I can play I think I can play I suck
Wrestling
Boxing
Football
Hockey
Rugby
Lacrosse
Other
Strength and Power
  2x
my own weight
1.5x
my own weight
1x
my own weight
.5x
my own weight
not sure
Squat
Deadlift
Bench Press
Military Press
Situation Response Questions

These questions are designed to make you think and give us a better understanding of your fight methodolgy. These factors will be reviewed on a personal basis and will be personally factored in to your results. We suggest that you also use the "Personal Response" area to be expand upon your reactions.

1.) A drunk man is hitting on your significant other and causing that person to feel uncomfortable? The man is bigger then you are, but very drunk and unaware of your presence. You are witness to the situation, what is your response?
  Personal Response:

Other

2.) You are at the movies and people are being extremely load directly behind you. It is a group of 3 twenty-something individuals. The movie theater is located in a fairly suburban area. Other patrons have "Shhshed" then from father away, but no response. What is your response?
  Personal Response:

Tell hem to "Shut Up"

2a.) None of your above reactions have had any affect. It is obvious that the individuals are looking for trouble and enjoying causing a problem. When you did talk to them, they laughed and are now taunting you, and at times kicking your seat. Next response?

Leave the theater
  Personal Response:

Attack.

3.) You are walking out of a city resturaunt and are approached by a thug looking for money, jewlery, etc. You have your wallet with your social security card, credit card, and $200. Your wife or significant other is wearing either a very expensive and priceless wedding ring or gift you have given her. He has not presented a gun, knife or other weapon.

Give him what he wants
  Personal Response:

Give him just cash.
Fight Response Questions

These following questions are similar to the situational response questions, but geared towards an actual fight. In all situations you are WITHOUT a weapon of your own. Personal Responses are encouraged.

1.) You are facing an irrate male who is bigger then you and aggressive in nature. He is swinging at you with a looping sucker punch. We are assuming you have the ability to see this punch coming. What is your response?

Step Back
  Personal Response:

Other.

2.) A man is charging at you full-force in an attempt to tackle you. You cannot avoid the hit, response?
  Personal Response:

Jump over him…?

3.) A gun is pointed at your chest. You are unsure of the intentions of the assialant. You can assume he wants your life, response?

Start praying.
  Personal Response:

Attempt to control the weapon

4.) A man is wielding a knife and is intent on stabbing you. You cannot run or escape, response?

Getting stabbed is cool!
  Personal Response:

Hit the knife out of his hand

Attempt to control weilding hand

5.) You are conerned by three men, one larger (the leader) and two average males, response?

Take a beating.
  Personal Response:

Attack smaller males first.

Attack leader first.
Othe Questions?
Why are you taking this test?
Are you concerned about self-defense?
Yes

No
 
Is someone threatening you or bothering you?
Yes

No
 
Are you interested in learning how to defend yourself?
Yes

No
 
Are you interested in competing in martial arts?
Yes

No
 
Are you looking for self-defense solutions?
Yes

No
 
Are you looking to improve strength and fighter’s fitness?
Yes

No
 
Your Information

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