AR-I (ATHLETE RECORD)
REGION III
Region
OLONGAPO CITY
Division
Latest 1 x 1 picture
A. PERSONAL DATA:
Name:
CHIA
FRANCES JAMIE
(First)
(M.I.)
(Last)
FEMALE Learner Reference Number (LRN)
Sex:
Date of Birth: (mm/dd/yy)
School:
Address of School:
Home Address:
Place of
Birth:
Age:
REGIONAL SCIENCE HIGH SCHOOL
Contact Number:
BEIS (Private School Number )
Parents:
Fathers Name
Mother/Guardian
Address of Parents:
B. Athlete's Participation in Local/International Competition
Inclusive Dates
Sports Event
Athletic Meet
Remarks
(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
Division PESS Supervisor/s
Signature
Division/Provincial Meet
Regional Meet
Palarong Pambansa
(Use separate sheet if necessary)
Screened by:
Division Meet
Regional Meet
(Signature over Printed Name)
Date:
FOR PALARONG PAMBANSA ONLY
(Signature over Printed Name)
Date: