NOTE Names should be in ALL CAPS and in Alphabetical order

Please follow how details/entries was encoded

Activity UNIVERSITY GAMES 2022 Campus Sports MARY JANE O. LIM
Date/host January , 10-13, 2023; ISU - Echague, Isabela Designation Campus Sports Director
ISABELA STATE UNIVERSITY Campus Roxas Campus
Event: VOLLEYBALL Registrar PURISIMA B. CANAPI, MAEd
Category: WOMEN'S Designation Registrar III *** NOTHING FOLLOWS***
Name ID Number Course Age Birthday School Contact Number
1 ABALOS, EDELYN 20-11111 BTTE 4 20 9/20/1999 ISU-ROXAS 0917-123-4567
2 BAÑARES, JANA MAE 20242210582 BSIT 1 19 03/20/2003 ISU-ROXAS 09477680000
3 ESPIRITU, OLIVIA 20242120002 BSIT 2 20 08/04/2002 ISU-ROXAS 09552702822
4 GAMLOSEN, MARY ANN 20242010241 BSIT 3 21 04/23/2001 ISU-ROXAS 09993217798
5 LAPUEBLA, JIREH JOYCE C. 20242110409 BSCRIM 2 20 12/29/2002 ISU-ROXAS 099356742700
6 LEGASPI, EDELITA 20-11116 BSA 2 21 6/13/1998 ISU-ROXAS 0917-123-4567
7 MANAGUELOD, ROCHELLE 20242110192 BSAB 2 19 11/16/2003 ISU-ROXAS 09368783787
8 MANZANO, ANGEL L. 20242110249 BSAB 2 20 02/21/2002 ISU-ROXAS 09707046334
9 RUIZ, ANGELICA B. 20241910089 BSE 4 21 03/18/2001 ISU-ROXAS 09158828349
10 SAMSON, REMIE ANN 20241910052 BSIT 4 22 06/21/2000 ISU-ROXAS 09169114233
11 SILVA, KORINA 20242111449 BSIT 1 21 12/11/2001 ISU-ROXAS 09355469122
12 TIBURCIO, KAREN JANE 20242010448 BSRIM 3 21 09/20/2001 ISU-ROXAS 09754971198
Co
CCo
Cha
 SCUAA Form 1
OFFICIAL ENTRY FORM AND GALLERY OF
UNIVERSITY GAMES 2022 VOLLEYBALL
January , 10-13, 2023; ISU - Echague, Isabela (Event)
Date of Screening: (please refer to the SCUAA National Games Manual)
Campus: ISABELA STATE UNIVERSITY - Roxas Campus Category: WOMEN'S
Name of Athlete 2X2 Picture
Course and Date of Birth Assessment NSO Birth
# (Family Name, First Name MI)
Year
Age
(mm – dd – yyyy)
FORM 2 FORM 3 TOR
Form Certificate
(no need to Remarks
In Alphabetical Order submit)

1 ABALOS, EDELYN BTTE 4 20 9/20/1999

2 BAÑARES, JANA MAE BSIT 1 19 03/20/2003
3 ESPIRITU, OLIVIA BSIT 2 20 08/04/2002
4 GAMLOSEN, MARY ANN BSIT 3 21 04/23/2001
5 LAPUEBLA, JIREH JOYCE C. BSCRIM 2 20 12/29/2002
6 LEGASPI, EDELITA BSA 2 21 6/13/1998
7 MANAGUELOD, ROCHELLE BSAB 2 19 11/16/2003
8 MANZANO, ANGEL L. BSAB 2 20 02/21/2002
9 RUIZ, ANGELICA B. BSE 4 21 03/18/2001
10 SAMSON, REMIE ANN BSIT 4 22 06/21/2000
11 SILVA, KORINA BSIT 1 21 12/11/2001
12 TIBURCIO, KAREN JANE BSRIM 3 21 09/20/2001

LARRY D. ELCHICO 0 MARY JANE O. LIM

Coach Assistant Coach Campus Sports Director
 SCUAA Form 2
OFFICIAL ENTRY FORM AND GALLERY OF
UNIVERSITY GAMES 2022 VOLLEYBALL
January , 10-13, 2023; ISU - Echague, Isabela (Event) page 1 of 1
Date of Screening: (please refer to the SCUAA National Games Manual)

Campus: ISABELA STATE UNIVERSITY - Roxas Campus Category: WOMEN'S

ATHLETE ATHLETE ATHLETE ATHLETE ATHLETE ATHLETE

1 2 3 4 5 6
1.65 x 1.65 Photo 1.65 x 1.65 Photo 1.65 x 1.65 Photo 1.65 x 1.65 Photo 1.65 x 1.65 Photo 1.65 x 1.65 Photo

Name: ABALOS, EDELYN BAÑARES, JANA MAE ESPIRITU, OLIVIA GAMLOSEN, MARY ANN LAPUEBLA, JIREH JOYCE C. LEGASPI, EDELITA
Date of Birth 20-Sep-1999 03/20/2003 08/04/2002 04/23/2001 29-Dec-2002 13-Jun-1998
Course & Year BTTE 4 BSIT 1 BSIT 2 BSIT 3 BSCRIM 2 BSA 2
School: ISU-ROXAS ISU-ROXAS ISU-ROXAS ISU-ROXAS ISU-ROXAS ISU-ROXAS
COACH CO-COACH CHAPERON
Eligibility UNIVERSITY GAMES 2020
Requirements:  
 
1.) Official Transcript of  
Records (OTR) with:
a.) complete scholastic
record of athlete.
1.65 x 1.65 Photo 1.65 x 1.65 Photo 1.65 x 1.65 Photo b.) subjects and grades of
University Seal
1st Sem, SY 2021-202  
c.) subjects enrolled for   
2nd Sem, SY 2021-2022
d.) scanned Picture of  
student
e.) School Dry Seal
2.) SCUAA Games Form
Name: 0 0 0 Numbers: 1, 2 & 3.
3.) NSO Birth Certificate
MARY JANE O. LIM
School 0 0 0 Campus Sports Director
 SCUAA Form 2
OFFICIAL ENTRY FORM AND GALLERY OF
UNIVERSITY GAMES 2022 VOLLEYBALL
January , 10-13, 2023; ISU - Echague, Isabela (Event) page 1 of 2
Date of Screening: (please refer to the SCUAA National Games Manual)

Campus: ISABELA STATE UNIVERSITY - Roxas Campus Category: WOMEN'S

ATHLETE ATHLETE ATHLETE ATHLETE ATHLETE ATHLETE

1 2 3 4 5 6
1.65 x 1.65 Photo 1.65 x 1.65 Photo 1.65 x 1.65 Photo 1.65 x 1.65 Photo 1.65 x 1.65 Photo 1.65 x 1.65 Photo

Name: ABALOS, EDELYN BAÑARES, JANA MAE ESPIRITU, OLIVIA GAMLOSEN, MARY ANN LAPUEBLA, JIREH JOYCE C. LEGASPI, EDELITA
Date of Birth 20-Sep-1999 03/20/2003 08/04/2002 04/23/2001 29-Dec-2002 13-Jun-1998
Course & Year BTTE 4 BSIT 1 BSIT 2 BSIT 3 BSCRIM 2 BSA 2
School: ISU-ROXAS ISU-ROXAS ISU-ROXAS ISU-ROXAS ISU-ROXAS ISU-ROXAS
COACH CO-COACH CHAPERON

7 8 9 10 11 12
1.65 x 1.65 Photo 1.65 x 1.65 Photo 1.65 x 1.65 Photo 1.65 x 1.65 Photo 1.65 x 1.65 Photo 1.65 x 1.65 Photo

Name: MANAGUELOD, ROCHELLE MANZANO, ANGEL L. RUIZ, ANGELICA B. SAMSON, REMIE ANN SILVA, KORINA TIBURCIO, KAREN JANE
Date of Birth 16-Nov-03 02/21/2002 03/18/2001 06/21/2000 11-Dec-01 09/20/2001
Course & Year BSAB 2 BSAB 2 BSE 4 BSIT 4 BSIT 1 BSRIM 3
School: ISU-ROXAS ISU-ROXAS ISU-ROXAS ISU-ROXAS ISU-ROXAS ISU-ROXAS
 SCUAA Form 2
OFFICIAL ENTRY FORM AND GALLERY OF
UNIVERSITY GAMES 2022 VOLLEYBALL
January , 10-13, 2023; ISU - Echague, Isabela (Event) page 2 of 2
Date of Screening: (please refer to the SCUAA National Games Manual)

Campus: ISABELA STATE UNIVERSITY - Roxas Campus Category: WOMEN'S

ATHLETE ATHLETE ATHLETE ATHLETE ATHLETE ATHLETE

13 14 15 16 17 18
1.65 x 1.65 Photo 1.65 x 1.65 Photo 1.65 x 1.65 Photo 1.65 x 1.65 Photo 1.65 x 1.65 Photo 1.65 x 1.65 Photo

Name: Err:509 Err:509 Err:509 Err:509 Err:509 Err:509

Date of Birth Err:509 Err:509 Err:509 Err:509 Err:509 Err:509
Course & Year Err:509 Err:509 Err:509 Err:509 Err:509 Err:509
School: Err:509 Err:509 Err:509 Err:509 Err:509 Err:509
COACH CO-COACH CHAPERON
Eligibility UNIVERSITY GAMES 2020
Requirements:  
 
1.) Official Transcript of  
Records (OTR) with:
a.) complete scholastic
1.65 x 1.65 Photo 1.65 x 1.65 Photo 1.65 x 1.65 Photo record of athlete.
b.) subjects and grades of
University Seal
1st Sem, SY 2021-2022.  
c.) subjects enrolled for   
2nd Sem, SY 201-2022
d.) scanned Picture of  
student
Name: 0 0 0 e.) School Dry Seal
2.) SCUAA Games Form
Numbers: 1, 2 & 3.
MARY JANE O. LIM
School 3.) NSO Birth Certificate Campus Sports Director
0 0 0
 ISABELA STATE UNIVERSITY
Roxas Campus

12-May-22

To whom it may concern:

This is to certify the students whose names appears below are currently enrolled this
2nd Semester School Year 2021 - 2022.

# Name ID Number Course

1 ABALOS, EDELYN 20-11111 BTTE 4
2 BAÑARES, JANA MAE 20242210582 BSIT 1
3 ESPIRITU, OLIVIA 20242120002 BSIT 2
4 GAMLOSEN, MARY ANN 20242010241 BSIT 3
5 LAPUEBLA, JIREH JOYCE C. 20242110409 BSCRIM 2
6 LEGASPI, EDELITA 20-11116 BSA 2
7 MANAGUELOD, ROCHELLE 20242110192 BSAB 2
8 MANZANO, ANGEL L. 20242110249 BSAB 2
9 RUIZ, ANGELICA B. 20241910089 BSE 4
10 SAMSON, REMIE ANN 20241910052 BSIT 4
11 SILVA, KORINA 20242111449 BSIT 1
12 TIBURCIO, KAREN JANE 20242010448 BSRIM 3
*** NOTHING FOLLOWS***

This certification is issued for the UNIVERSITY GAMES 2023 purposes only.

PURISIMA B. CANAPI, MAEd

Registrar III
Not Valid without the Official Seal