PSC Form (Revised 2019)
* Kindly accomplish this form and submit to NSA Affairs Office with complete details. Indicate N/A if not applicable.
PROFILE FORM - C
** Photocopy of Birth Certificate, passport and Certificates of participation or attendance must be attached to this form
SPORT PENCAK SILAT EVENT/CATEGORY TANDING
CLASSIFICATION ASSISTANT COACH
PERSONAL INFORMATION
SURNAME HUINDA
NAME EXTENSION (JR., SR)
FIRST NAME NERLYN
MIDDLE NAME LAUTERIO
NATIONAL COACH SINCE 2015-PRESENT CITIZENSHIP
DATE OF BIRTH
(mm/dd/yyyy) 3/29/1981 FILIPINO PHILIPPINES
PLACE OF BIRTH CUARTERO CAPIZ If holder of dual citizenship, Pls. indicate country:
please indicate the details.
SEX FEMALE
CIVIL STATUS PROVINCIAL ADDRESS
SINGLE
House/Block/Lot No. Street/Subdivision/Village
BRGY. MAINIT CUARTERO, CAPIZ
Barangay/City/Municipality PROVINCE
RESIDENTIAL ADDRESS RMSC VITO CRUZ
House/Block/Lot No. Street/Subdivision/Village
MALATE MANILA
PSC ID NUMBER PENOFF-004
Barangay/City/Municipality Province
HEIGHT (m) 5'1 WEIGHT (kg) 70kg BLOOD TYPE O
PASSPORT NUMBER P5884049 PASSPORT VALID UNTIL 2-1-28 LANDBANK ACCOUNT NUMBER SA 1777 06 4661
CONTACT INFORMATION
TELEPHONE NUMBER N/A EMAIL ADDRESS huindanerlyn25@gmail.com
SOCIAL MEDIA ACCOUNTS USERNAME
MOBILE NUMBER 09388831310 (Facebook, Twitter, Instagram, etc.) N/A
FAMILY BACKGROUND
SPOUSE'S NAME (Surname, NAME of CHILDREN (Write full name and list all) DATE OF BIRTH
First Name, Middle Name) (mm/dd/yyyy)
OCCUPATION
EMPLOYER/BUSINESS NAME
TELEPHONE NO.
FATHER'S NAME (Surname,
First Name, Middle Name) HUINDA, PEDRO APOLINARIO
MOTHER'S NAME (Surname,
First Name, Middle Name) HUINDA, NERSES HEROSA
(Continue on separate sheet if necessary)
HIGHEST
NAME OF SCHOOL BASIC EDUCATION/DEGREE/COURSE PERIOD OF LEVEL/ YEAR
ATTENDANCE UNITS
LEVEL (Write in full) EARNED GRADUATED
(Write in full) (if not
From To graduated)
ELEMENTARY
CUARTERO ELEMENTARY 6/10/1988 3/29/1994 1994
VOCATIONAL / SCHOOL
SECONDARY
CUARTERO NATIONAL HIGH 6/10/1994 3/27/1998 1998
SCHOOL. SCHOOL
N/A
COLLEGE
PHILIPPINE COLLEGE OF 9/10/2002 4/1/2003
CRIMINOLOGY
TRADE COURSE
GRADUATE STUDIES
SPECIMEN SIGNATUREOF COACH DATE February 10, 2018
For Enlisted Personnel Only
UNIT BADGE NUMBER
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FORM - COACH
ountry:
n/Village
n/Village
06 4661
E OF BIRTH
m/dd/yyyy)
SCHOLARSHIP
/ ACADEMIC
HONORS
RECEIVED
, 2018
SPORTS CAREER RECORDS - MEDALISTS PRODUCED
YEAR NAME OF ATHLETE COMPETITION / EVENT
18th WORLD PENCAK SILAT CHAMPIONSHIP
2018 CHERRY MAE REGALADO
(TUNGGAL, FEMALE)
2018 JEFFERSON RHEY LOON 18th WORLD PENCAK SILAT CHAMPIONSHIP (REGU)
2018 JAMES EL MAYAGMA 18th WORLD PENCAK SILAT CHAMPIONSHIP (REGU)
2018 RICK ROD ORTEGA 18th WORLD PENCAK SILAT CHAMPIONSHIP (REGU)
2018 RACHEL LLAVORE 18th WORLD PENCAK SILAT CHAMPIONSHIP (CLASS A)
2018 JACERIN ABAD 18th WORLD PENCAK SILAT CHAMPIONSHIP (CLASS B)
2018 CHERRY MAE REGALADO 18th ASIAN GAMES INDONESIA
2018 ALMOHAIDIB ABAD 18th ASIAN GAMES INDONESIA
2018 DINES DUMAAN 18th ASIAN GAMES INDONESIA
2018 JEFFERSON RHEY LOON 18th ASIAN GAMES INDONESIA
2018 CHERRY MAE REGALADO PRE-ASIAN GAMES
2018 DINES DUMAAN PRE-ASIAN GAMES
2018 PRINCESSLYN ENOPIA PRE-ASIAN GAMES
2018 PRECIOUS JADE BORRE PRE-ASIAN GAMES
2018 TRISHA MARIE LEDA PRE-ASIAN GAMES
2018 ALFAU JAN ABAD PRE-ASIAN GAMES
2018 ALMOHAIDIB ABAD PRE-ASIAN GAMES
2018 ALVIN CAMPOS PRE-ASIAN GAMES
BRONZE
LOCAL SEMINARS/TRAININGS/ACCREDITATION/JUDGES LICENSE UPGRADE (Please attach Certificates of participation or attendance)
YEAR TITLE OF EVENT LEVEL
SEP 14-15, 2017 KOREA INSTITUTE OF SPORT SCIENCE LECTURE SERIES IN PARTNERSHIP COMPLETED
MAY 2016 CHANGING LIVES THROUGH COACHING COMPLETED
APRIL 21,2016 SERIES 9: THEORY AND PRACTICAL APPLICATION OF FUNCTIONAL MOVEMENT COMPLETED
APRIL 18-19, 2016 SERIES 8: SPORTS SPECIFIC FUNCTIONAL MOVEMENT COMPLETED
SEP 20, 2016 UNDERSTANDING THE PSYCHE OF A WOMAN ATHLETE COMPLETED
SEP 21, 2016 HOLISTIC DEVELOPMENT SEMINAR BASIC FIRST AID COMPLETED
SEP 22, 2016 HOLISTIC DEVELOPMENT SEMINAR BASIC SURVIVAL MEDICAL FIRST AID COMPLETED
SEP. 23, 2016 HOLISTIC DEVELOPMENT SEMINAR PUTTING YOUR BEST FOOT FORWARD COMPLETED
OCT. 28, 2016 HOLISTIC DEVELOPMENT SEMINAR THE IMPORTANCE OF YOGA FOR SPORTS PERSON COMPLETED
OCT. 27, 2016 HOLISTIC DEVELOPMENT SEMINAR BASIC FIRST AID COMPLETED
OCT. 25, 2016 HOLISTIC DEVELOPMENT SEMINAR STRESS MANAGEMENT COMPLETED
OCT. 25, 2016 HOLISTIC DEVELOPMENT SEMINAR MENTAL TOUGHNESS COMPLETED
MARCH 1, 2003 REPLICATING DOLLY: DNA AS A FORENSIC TOOL COMPLETED
AUGUST 15-17, 2003 TRAFFIC SAFETY EDUCATION AND ACCIDENT INVESTIGATION PROGRAM COMPLETED
MAY 14- APRIL 23,
WEEKS TRAINING AND FRIENDSHIP GAMES COMPLETED
2017
SEP. 19 2013 CERTIFICATE OF COACHING LICENSE COMPLETED
FEB. 11, 2015 CERTIFICATE OF REFEREE-JURY LICENSE COMPLETED
JULY 30, 2016 CERTIFICATE OF INSTRUCTOR LICENSE COMPLETED
(Continue on separate sheet if necessary)
I declare under oath that I have personally accomplished this Profile Form which is a true, correct and complete statement pursuant to the provisions of pertinent laws, rules a
and other government agencies to verify/validate the contents stated herein. I agree that any misrepresentation made in this document and its attachments shall cau
SIGNATURE OF COACH
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COUNTRY / VENUE MEDAL / RANK (Indicate
number of participants)
SINGAPORE SILVER
SINGAPORE SILVER
SINGAPORE SILVER
SINGAPORE SILVER
SINGAPORE BRONZE
SINGAPORE BRONZE
DONESIA BRONZE
DONESIA BRONZE
DONESIA BRONZE
DONESIA BRONZE
INDONESIA GOLD
INDONESIA SILVER
INDONESIA SILVER
INDONESIA SILVER
INDONESIA SILVER
INDONESIA SILVER
INDONESIA SILVER
INDONESIA BRONZE
COUNTRY / VENUE
ULTRA, PASIG CITY
AVR, PHILSPORTS COMPLEX
PHILSPORTS COMPLEX
PHILSPORTS COMPLEX
PHILSPORTS COMPLEX
RIZAL MEMORIAL COLISEUM
MALATE, MANILA
MALATE, MANILA
RIZAL MEMORIAL COLISEUM
RIZAL MEMORIAL COLISEUM
RIZAL MEMORIAL COLISEUM
RIZAL MEMORIAL COLISEUM
STA. CRUZ MANILA
PORT AREA MANILA
YALA, THAILAND
RAMON MAGSAYSAY STATE UNIVERSITY, IBA, ZAMBALES
TUGUEGARAO CITY
RMSC CENTRAL GYM, MANILA
ws, rules and regulations of the Republic of the Philippines. I authorize PSC
s shall cause the filing of administrative/criminal case/s against me.
2/10/2018
DATE ACCOMPLISHED
