AR-I (ATHLETE RECORD)
Region
Division Latest 1 x 1 picture
A. PERSONAL DATA:
Name:
(Last) (First) (M.I.)
Sex: Learner Reference Number (LRN) Contact Number:
Date of Birth: (mm/dd/yy) Age: Place of Birth:
School: BEIS (Private School Number )
Address of School:
Home Address:
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 Signature Division PESS Supervisor/s
(Use separate sheet if necessary)
Screened by:
Division Meet Regional Meet
(Signature over Printed Name) (Signature over Printed Name)
Date: Date:
FOR PALARONG PAMBANSA ONLY
RECORD)
picture
rdian
Remarks
upervisor/s
ed Name)