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Zerland NATIONAL FEDERATION Russian Taekwondo Union FULL NAME: Gennady Deriuzhkin CONTACT PERSON E-MAIL: tkd@roc.ru FULL ATHLETE NAME (NAME MUST MATCH LEGAL ID & INCLUDE EVERY AND ALL PARTS OF THE NAME) FULL ATHLETE NAME FIRST NAME: Ivan FULL ATHLETE NAME LAST NAME: Ivanov MIDDLE NAME: PREFERRED NAME (NAME SHOWN ON LICENCE CARD & USED AT COMPETITIONS – LAST NAME IN CAPITAL LETTERS) PREFERRED NAME FIRST NAME: Ivan STREET: ADDRESS M F 19a 173 Kirova ZIP/POSTCODE: E-MAIL GENDE.

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