Athlete Record

AR-I (ATHLETE RECORD)
I
Region
ILOCOS SUR
Division Latest 1½ x 1½ picture
A. PERSONAL DATA:
Name: BERMUNDO, CARMELA D.

(Last) (First) (M.I.)
Sex: Female Learner Reference Number (LRN) 100627080020 Contact Number:

Date of Birth: (mm/dd/yy) 08 / 26 / 2003 Age: 14 Place of Birth: SANTA, ILOCOS SUR
School: SANTA HIGH SCHOOL, INCORPORATED BEIS (Private School Number ) 400044
Address of School: QUIRINO DISTRICT, SANTA, ILOCOS SUR
Home Address: QUEZON DISTRICT, SANTA, ILOCOS SUR
Parents: JOEL JESUS BERMUNDO ELIZA DANIEL
Fathers Name Mother/Guardian
Address of Parents: QUEZON DISTRICT, SANTA, ILOCOS SUR
B. Athlete's Participation in Local/International Competition

Inclusive Dates Sports Event Athletic Meet Remarks
September 10-11, 2017 Basketball Girls Santa District Meet 2017 Champion
September 22-24, 2017 Basketball Girls Unit II Athletic Meet 2017 Champion
(Use separate sheet if necessary)
Athlete's Signature
C. Athlete's Participation
This is to certify that based on our knowledge the above-mentioned athlete has participated
in the lower meets.
Athletic meet Name of Coach Signature Division PESS Supervisor/s
Division/Provincial Meet Rogelio G. Berbano
Regional Meet
Palarong Pambansa
Screened by:
Division Meet Regional Meet
(Signature over Printed Name) (Signature over Printed Name)
Date: Date:
FOR PALARONG PAMBANSA ONLY
I
Region
ILOCOS SUR
A. PERSONAL DATA:
Name: CARANZO, CIRENE A.


Date of Birth: (mm/dd/yy) 12 / 18 / 2000 Age: 16 Place of Birth: SANTA, ILOCOS SUR
Home Address: SAN JOSE, SANTA, ILOCOS SUR
Parents: JEZREEL CARANZO LOLITA ABAPO
Address of Parents: SAN JOSE, SANTA, ILOCOS SUR

Athlete's Signature
in the lower meets.
Regional Meet
Palarong Pambansa
Screened by:
Date: Date:
I
Region
ILOCOS SUR
A. PERSONAL DATA:
Name: BALDONADO, JUSTINE ANNE A.


Date of Birth: (mm/dd/yy) 5/9/2000 Age: 17
SANTA, ILOCOS SUR
Place of Birth:
Home Address: SACUYYA NORTE, SANTA, ILOCOS SUR
Parents: JOSEPH BALDONADO TERESITA ABAD
Address of Parents: SACUYYA NORTE, SANTA, ILOCOS SUR

Athlete's Signature
in the lower meets.
Regional Meet
Palarong Pambansa
Screened by:
Date: Date:

I
Region
ILOCOS SUR
A. PERSONAL DATA:
Name: MOLINA, MICAH B.


Date of Birth: (mm/dd/yy) 10 / 22 / 2003 Age: 14
SANTA, ILOCOS SUR
Place of Birth:
Home Address: LABUT NORTE, SANTA, ILOCOS SUR
Parents: ROWEL MOLINA JENIE BRINGAS
Address of Parents: LABUT NORTE, SANTA, ILOCOS SUR

Athlete's Signature
in the lower meets.
Regional Meet
Palarong Pambansa
Screened by:
Date: Date:

I
Region
ILOCOS SUR
A. PERSONAL DATA:
Name: PAGLINGAYEN, ZARINNA C.


Date of Birth: (mm/dd/yy) 07/16/2001 Age: 16 Place of Birth: TAMAG, VIGAN CITY
Home Address: PASUNGOL, SANTA, ILOCOS SUR
Parents: FERDINAND PAGLINGAYEN (D) JENNY PAGLINGAYEN
Address of Parents: PASUNGOL, SANTA, ILOCOS SUR

Athlete's Signature
in the lower meets.
Regional Meet
Palarong Pambansa
Screened by:
Date: Date:

Athlete Record

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AR-I (ATHLETE RECORD)

Name: BERMUNDO, CARMELA D.

Sex: Female Learner Reference Number (LRN) 100627080020 Contact Number:

B. Athlete's Participation in Local/International Competition

(Use separate sheet if necessary)

(Use separate sheet if necessary)

Division Meet Regional Meet

(Signature over Printed Name) (Signature over Printed Name)

Name: CARANZO, CIRENE A.

Sex: Female Learner Reference Number (LRN) 100627060022 Contact Number:

B. Athlete's Participation in Local/International Competition

(Use separate sheet if necessary)

(Use separate sheet if necessary)

Division Meet Regional Meet

(Signature over Printed Name) (Signature over Printed Name)

Name: BALDONADO, JUSTINE ANNE A.

Sex: Female Learner Reference Number (LRN) 100626060005 Contact Number:

B. Athlete's Participation in Local/International Competition

(Use separate sheet if necessary)

(Use separate sheet if necessary)

Division Meet Regional Meet

(Signature over Printed Name) (Signature over Printed Name)

FOR PALARONG PAMBANSA ONLY

Name: MOLINA, MICAH B.

Sex: Female Learner Reference Number (LRN) 100627080039 Contact Number:

B. Athlete's Participation in Local/International Competition

(Use separate sheet if necessary)

(Use separate sheet if necessary)

Division Meet Regional Meet

(Signature over Printed Name) (Signature over Printed Name)

FOR PALARONG PAMBANSA ONLY

Name: PAGLINGAYEN, ZARINNA C.

Sex: Female Learner Reference Number (LRN) 100620070020 Contact Number:

B. Athlete's Participation in Local/International Competition

(Use separate sheet if necessary)

(Use separate sheet if necessary)

Division Meet Regional Meet

(Signature over Printed Name) (Signature over Printed Name)

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