Revised as of September 26, 2019

AR (ATHLETE RECORD)

XI
Region

PANABO CITY
Division Latest 1½ x 1½ picture

A. PERSONAL DATA:

Name: ABELLON JOHN PAUL H

(Last) (First) (M.I.)

Sex: Male Learner Reference Number (LRN) 129678100002 Contact Number N/A
Date of Birth: (mm/dd/yyyy) 02/16/2005 Age: 18 Place of Birth: DAVAO CITY
School: A.O. FLOIRENDO NATIONAL HIGH SCHOOL Grade Level 11
Address of School: BRGY. A.O. FLOIRENDO, PANABO CITY
Present Address: TIBUNGOL, PANDAITAN, DAVAO CITY
Parents: ORLANDO B. ABELLON MARIA ROSALIE S. HATAGI
Fathers Name Mother/Guardian
Address of Parents/Guardian: TIBUNGOL, PANDAITAN, DAVAO CITY

B. Participation in the previous Palarong Pambansa. Yes ____ No _____ . If Yes, kindly fill up the table below
Year of Participation Sports Event Venue Remarks

C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks
Jan. 13-14, 20-21, 2023 Sepak Takraw Intramurals Qualified

(Use separate sheet if necessary)

Athlete's Signature over Printed Name

D. Certification on Athlete's Participation

This is to certify that based on our knowledge, the above-mentioned athlete has participated in the lower meets.

Name and Signature of Division Name and Signature of Regional Sports Officer
Meet Name and Signature of Coach
Sports Officer (DSO) (RSO)

Intramurals Christian Dave M. Ranolas

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet Palarong Pambansa

ANTONIO R. PASQUITO JR GEORGE N. WONG, EdD.

(Signature of DSAC over Printed Name) (Signature of RSAC over Printed Name) (Signature of NSAC over Printed Name)

Date: ______________ Date: ______________ Date: ______________

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

Revised as of September 26, 2019

AR (ATHLETE RECORD)

XI
Region

PANABO CITY
Division Latest 1½ x 1½ picture

A. PERSONAL DATA:

Name: BAG-O JAKE SAMUEL B.

(Last) (First) (M.I.)

Sex: Male Learner Reference Number (LRN) 118687140004 Contact Number 9565549157
Date of Birth: (mm/dd/yyyy) 11/7/2009 Age: 13 Place of Birth: PANABO CITY
School: A.O. FLOIRENDO NATIONAL HIGH SCHOOL Grade Level 7
Address of School: BRGY. A.O. FLOIRENDO, PANABO CITY
Present Address: BRGY. A.O. FLOIRENDO, PANABO CITY
Parents: RICHARD A. BAG-O JONALYN D. BAG-O
Fathers Name Mother/Guardian
Address of Parents/Guardian: BRGY. A.O. FLOIRENDO, PANABO CITY

B. Participation in the previous Palarong Pambansa. Yes ____ No _____ . If Yes, kindly fill up the table below
Year of Participation Sports Event Venue Remarks

C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks
Jan. 13-14, 20-21, 2023 Sepak Takraw Intramurals Qualified

(Use separate sheet if necessary)

Athlete's Signature over Printed Name

D. Certification on Athlete's Participation

This is to certify that based on our knowledge, the above-mentioned athlete has participated in the lower meets.

Name and Signature of Division Name and Signature of Regional Sports Officer
Meet Name and Signature of Coach
Sports Officer (DSO) (RSO)

Intramurals Christian Dave M. Ranolas

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet Palarong Pambansa

ANTONIO R. PASQUITO JR GEORGE N. WONG, EdD.

(Signature of DSAC over Printed Name) (Signature of RSAC over Printed Name) (Signature of NSAC over Printed Name)

Date: ______________ Date: ______________ Date: ______________

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

Revised as of September 26, 2019

AR (ATHLETE RECORD)

XI
Region

PANABO CITY
Division Latest 1½ x 1½ picture

A. PERSONAL DATA:

Name: BONOTAN ERIC JHON A.

(Last) (First) (M.I.)

Sex: Male Learner Reference Number (LRN) 12978912004 Contact Number 9274310491
Date of Birth: (mm/dd/yyyy) 11/29/2006 Age: 16 Place of Birth: PANABO CITY
School: A.O. FLOIRENDO NATIONAL HIGH SCHOOL Grade Level 10
Address of School: BRGY. A.O. FLOIRENDO, PANABO CITY
Present Address: BRGY. A.O. FLOIRENDO, PANABO CITY
Parents: ROY C. BONOTAN WILMA B. ARNAIZ
Fathers Name Mother/Guardian
Address of Parents/Guardian: BRGY. A.O. FLOIRENDO, PANABO CITY

B. Participation in the previous Palarong Pambansa. Yes ____ No _____ . If Yes, kindly fill up the table below
Year of Participation Sports Event Venue Remarks

C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks
Jan. 13-14, 20-21, 2023 Sepak Takraw Intramurals Qualified

(Use separate sheet if necessary)

Athlete's Signature over Printed Name

D. Certification on Athlete's Participation

This is to certify that based on our knowledge, the above-mentioned athlete has participated in the lower meets.

Name and Signature of Division Name and Signature of Regional Sports Officer
Meet Name and Signature of Coach
Sports Officer (DSO) (RSO)

Intramurals Christian Dave M. Ranolas

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet Palarong Pambansa

ANTONIO R. PASQUITO JR GEORGE N. WONG, EdD.

(Signature of DSAC over Printed Name) (Signature of RSAC over Printed Name) (Signature of NSAC over Printed Name)

Date: ______________ Date: ______________ Date: ______________

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

Revised as of September 26, 2019

AR (ATHLETE RECORD)

XI
Region

PANABO CITY
Division Latest 1½ x 1½ picture

A. PERSONAL DATA:

Name: CALAGO JOSHUA T.

(Last) (First) (M.I.)

Sex: Male Learner Reference Number (LRN) 129587110009 Contact Number 9518246499
Date of Birth: (mm/dd/yyyy) 03/25/2006 Age: 16 Place of Birth: DAVAO CITY
School: A.O. FLOIRENDO NATIONAL HIGH SCHOOL Grade Level 11
Address of School: BRGY. A.O. FLOIRENDO, PANABO CITY
Present Address: BRGY. SINDATON, PANABO CITY
Parents: VERGILIO, JR. P. CALAGO JENNIFER P. TORREJAS
Fathers Name Mother/Guardian
Address of Parents/Guardian: BRGY. SINDATON, PANABO CITY

B. Participation in the previous Palarong Pambansa. Yes ____ No _____ . If Yes, kindly fill up the table below
Year of Participation Sports Event Venue Remarks

C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks
Jan. 13-14, 20-21, 2023 Sepak Takraw Intramurals Qualified

(Use separate sheet if necessary)

Athlete's Signature over Printed Name

D. Certification on Athlete's Participation

This is to certify that based on our knowledge, the above-mentioned athlete has participated in the lower meets.

Name and Signature of Division Name and Signature of Regional Sports Officer
Meet Name and Signature of Coach
Sports Officer (DSO) (RSO)

Intramurals Christian Dave M. Ranolas

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet Palarong Pambansa

ANTONIO R. PASQUITO JR GEORGE N. WONG, EdD.

(Signature of DSAC over Printed Name) (Signature of RSAC over Printed Name) (Signature of NSAC over Printed Name)

Date: ______________ Date: ______________ Date: ______________

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

Revised as of September 26, 2019

AR (ATHLETE RECORD)

XI
Region

PANABO CITY
Division Latest 1½ x 1½ picture

A. PERSONAL DATA:

Name: ESTILO PAUL CHRISTIAN C.

(Last) (First) (M.I.)

Sex: Male Learner Reference Number (LRN) 128765150263 Contact Number N/A
Date of Birth: (mm/dd/yyyy) 12/15/2009 Age: 13 Place of Birth: COTABATO
School: A.O. FLOIRENDO NATIONAL HIGH SCHOOL Grade Level 7
Address of School: BRGY. A.O. FLOIRENDO, PANABO CITY
Present Address: BRGY. A.O. FLOIRENDO, PANABO CITY
Parents: ALBERT A. ESTILO LORENA H. CATOLICO
Fathers Name Mother/Guardian
Address of Parents/Guardian: BRGY. A.O. FLOIRENDO, PANABO CITY

B. Participation in the previous Palarong Pambansa. Yes ____ No _____ . If Yes, kindly fill up the table below
Year of Participation Sports Event Venue Remarks

C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks
Jan. 13-14, 20-21, 2023 Sepak Takraw Intramurals Qualified

(Use separate sheet if necessary)

Athlete's Signature over Printed Name

D. Certification on Athlete's Participation

This is to certify that based on our knowledge, the above-mentioned athlete has participated in the lower meets.

Name and Signature of Division Name and Signature of Regional Sports Officer
Meet Name and Signature of Coach
Sports Officer (DSO) (RSO)

Intramurals Christian Dave M. Ranolas

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet Palarong Pambansa

ANTONIO R. PASQUITO JR GEORGE N. WONG, EdD.

(Signature of DSAC over Printed Name) (Signature of RSAC over Printed Name) (Signature of NSAC over Printed Name)

Date: ______________ Date: ______________ Date: ______________

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

Revised as of September 26, 2019

AR (ATHLETE RECORD)

XI
Region

PANABO CITY
Division Latest 1½ x 1½ picture

A. PERSONAL DATA:

Name: INDRINA RHORENZ MARKJIL D.

(Last) (First) (M.I.)

Sex: Male Learner Reference Number (LRN) 129099140282 Contact Number N/A
Date of Birth: (mm/dd/yyyy) 8/11/2008 Age: 14 Place of Birth: DAVAO CITY
School: A.O. FLOIRENDO NATIONAL HIGH SCHOOL Grade Level 8
Address of School: BRGY. A.O. FLOIRENDO, PANABO CITY
Present Address: BRGY. A.O. FLOIRENDO, PANABO CITY
Parents: RONALD A. INDRINA KAREN M. DUTERTE
Fathers Name Mother/Guardian
Address of Parents/Guardian: BRGY. A.O. FLOIRENDO, PANABO CITY

B. Participation in the previous Palarong Pambansa. Yes ____ No _____ . If Yes, kindly fill up the table below
Year of Participation Sports Event Venue Remarks

C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks
Jan. 13-14, 20-21, 2023 Sepak Takraw Intramurals Qualified

(Use separate sheet if necessary)

Athlete's Signature over Printed Name

D. Certification on Athlete's Participation

This is to certify that based on our knowledge, the above-mentioned athlete has participated in the lower meets.

Name and Signature of Division Name and Signature of Regional Sports Officer
Meet Name and Signature of Coach
Sports Officer (DSO) (RSO)

Intramurals Christian Dave M. Ranolas

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet Palarong Pambansa

ANTONIO R. PASQUITO JR GEORGE N. WONG, EdD.

(Signature of DSAC over Printed Name) (Signature of RSAC over Printed Name) (Signature of NSAC over Printed Name)

Date: ______________ Date: ______________ Date: ______________

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

Revised as of September 26, 2019

AR (ATHLETE RECORD)

XI
Region

PANABO CITY
Division Latest 1½ x 1½ picture

A. PERSONAL DATA:

Name: JUMALON ZYRIEL P.

(Last) (First) (M.I.)

Sex: Male Learner Reference Number (LRN) 129738160660 Contact Number N/A
Date of Birth: (mm/dd/yyyy) 03/24/2008 Age: 14 Place of Birth: DAVAO CITY
School: A.O. FLOIRENDO NATIONAL HIGH SCHOOL Grade Level 9
Address of School: BRGY. A.O. FLOIRENDO, PANABO CITY
Present Address: BRGY. SINDATON, PANABO CITY
Parents: NOVIE KARLO Q. JUMALON ROSALINDA G. PARILLA
Fathers Name Mother/Guardian
Address of Parents/Guardian: BRGY. SINDATON, PANABO CITY

B. Participation in the previous Palarong Pambansa. Yes ____ No _____ . If Yes, kindly fill up the table below
Year of Participation Sports Event Venue Remarks

C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks
Jan. 13-14, 20-21, 2023 Sepak Takraw Intramurals Qualified

(Use separate sheet if necessary)

Athlete's Signature over Printed Name

D. Certification on Athlete's Participation

This is to certify that based on our knowledge, the above-mentioned athlete has participated in the lower meets.

Name and Signature of Division Name and Signature of Regional Sports Officer
Meet Name and Signature of Coach
Sports Officer (DSO) (RSO)

Intramurals Christian Dave M. Ranolas

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet Palarong Pambansa

ANTONIO R. PASQUITO JR GEORGE N. WONG, EdD.

(Signature of DSAC over Printed Name) (Signature of RSAC over Printed Name) (Signature of NSAC over Printed Name)

Date: ______________ Date: ______________ Date: ______________

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

Revised as of September 26, 2019

AR (ATHLETE RECORD)

XI
Region

PANABO CITY
Division Latest 1½ x 1½ picture

A. PERSONAL DATA:

Name: LAPITAN DAWYNE M

(Last) (First) (M.I.)

Sex: Male Learner Reference Number (LRN) 129800110010 Contact Number 9958949348
Date of Birth: (mm/dd/yyyy) 07/13/2006 Age: 16 Place of Birth: PANABO CITY
School: A.O. FLOIRENDO NATIONAL HIGH SCHOOL Grade Level 11
Address of School: BRGY. A.O. FLOIRENDO, PANABO CITY
Present Address: BRGY. A.O. FLOIRENDO, PANABO CITY
Parents: JULITO S. LAPITAN MARESTILA P. MARCOS
Fathers Name Mother/Guardian
Address of Parents/Guardian: BRGY. A.O. FLOIRENDO, PANABO CITY

B. Participation in the previous Palarong Pambansa. Yes ____ No _____ . If Yes, kindly fill up the table below
Year of Participation Sports Event Venue Remarks

C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks
Jan. 13-14, 20-21, 2023 Sepak Takraw Intramurals Qualified

(Use separate sheet if necessary)

Athlete's Signature over Printed Name

D. Certification on Athlete's Participation

This is to certify that based on our knowledge, the above-mentioned athlete has participated in the lower meets.

Name and Signature of Division Name and Signature of Regional Sports Officer
Meet Name and Signature of Coach
Sports Officer (DSO) (RSO)

Intramurals Christian Dave M. Ranolas

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet Palarong Pambansa

ANTONIO R. PASQUITO JR GEORGE N. WONG, EdD.

(Signature of DSAC over Printed Name) (Signature of RSAC over Printed Name) (Signature of NSAC over Printed Name)

Date: ______________ Date: ______________ Date: ______________

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

Revised as of September 26, 2019

AR (ATHLETE RECORD)

XI
Region

PANABO CITY
Division Latest 1½ x 1½ picture

A. PERSONAL DATA:

Name: MANGCO JAY VEE N.

(Last) (First) (M.I.)

Sex: Male Learner Reference Number (LRN) 129678100051 Contact Number N/A
Date of Birth: (mm/dd/yyyy) 5/10/2005 Age: 17 Place of Birth: DAVAO CITY
School: A.O. FLOIRENDO NATIONAL HIGH SCHOOL Grade Level 11
Address of School: BRGY. A.O. FLOIRENDO, PANABO CITY
Present Address: TIBUNGOL, PANDAITAN, DAVAO CITY
Parents: GIOVANNI B. MANGCO JENIFER N. NOVENO
Fathers Name Mother/Guardian
Address of Parents/Guardian: TIBUNGOL, PANDAITAN, DAVAO CITY

B. Participation in the previous Palarong Pambansa. Yes ____ No _____ . If Yes, kindly fill up the table below
Year of Participation Sports Event Venue Remarks

C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks
Jan. 13-14, 20-21, 2023 Sepak Takraw Intramurals Qualified

(Use separate sheet if necessary)

Athlete's Signature over Printed Name

D. Certification on Athlete's Participation

This is to certify that based on our knowledge, the above-mentioned athlete has participated in the lower meets.

Name and Signature of Division Name and Signature of Regional Sports Officer
Meet Name and Signature of Coach
Sports Officer (DSO) (RSO)

Intramurals Christian Dave M. Ranolas

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet Palarong Pambansa

ANTONIO R. PASQUITO JR GEORGE N. WONG, EdD.

(Signature of DSAC over Printed Name) (Signature of RSAC over Printed Name) (Signature of NSAC over Printed Name)

Date: ______________ Date: ______________ Date: ______________

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

Revised as of September 26, 2019

AR (ATHLETE RECORD)

XI
Region

PANABO CITY
Division Latest 1½ x 1½ picture

A. PERSONAL DATA:

Name: MIRANDA KHEN DRIC S.

(Last) (First) (M.I.)

Sex: Male Learner Reference Number (LRN) 129978130014 Contact Number 9755002138
Date of Birth: (mm/dd/yyyy) 04/16/2007 Age: 15 Place of Birth: COTABATO
School: A.O. FLOIRENDO NATIONAL HIGH SCHOOL Grade Level 10
Address of School: BRGY. A.O. FLOIRENDO, PANABO CITY
Present Address: BRGY. A.O. FLOIRENDO, PANABO CITY
Parents: RENE G. MIRANDA MARY JOY M. SELENDRON
Fathers Name Mother/Guardian
Address of Parents/Guardian: BRGY. A.O. FLOIRENDO, PANABO CITY

B. Participation in the previous Palarong Pambansa. Yes ____ No _____ . If Yes, kindly fill up the table below
Year of Participation Sports Event Venue Remarks

C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks
Jan. 13-14, 20-21, 2023 Sepak Takraw Intramurals Qualified

(Use separate sheet if necessary)

Athlete's Signature over Printed Name

D. Certification on Athlete's Participation

This is to certify that based on our knowledge, the above-mentioned athlete has participated in the lower meets.

Name and Signature of Division Name and Signature of Regional Sports Officer
Meet Name and Signature of Coach
Sports Officer (DSO) (RSO)

Intramurals Christian Dave M. Ranolas

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet Palarong Pambansa

ANTONIO R. PASQUITO JR GEORGE N. WONG, EdD.

(Signature of DSAC over Printed Name) (Signature of RSAC over Printed Name) (Signature of NSAC over Printed Name)

Date: ______________ Date: ______________ Date: ______________

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

Revised as of September 26, 2019

AR (ATHLETE RECORD)

XI
Region

PANABO CITY
Division Latest 1½ x 1½ picture

A. PERSONAL DATA:

Name: PARANAS JAMES HARVEY P

(Last) (First) (M.I.)

Sex: Male Learner Reference Number (LRN) 129789120066 Contact Number 9059188806
Date of Birth: (mm/dd/yyyy) 10/26/2007 Age: 15 Place of Birth: DAVAO CITY
School: A.O. FLOIRENDO NATIONAL HIGH SCHOOL Grade Level 9
Address of School: BRGY. A.O. FLOIRENDO, PANABO CITY
Present Address: BRGY. A.O. FLOIRENDO, PANABO CITY
Parents: JONE D. PARANAS JUVY A. POJAS
Fathers Name Mother/Guardian
Address of Parents/Guardian: BRGY. A.O. FLOIRENDO, PANABO CITY

B. Participation in the previous Palarong Pambansa. Yes ____ No _____ . If Yes, kindly fill up the table below
Year of Participation Sports Event Venue Remarks

C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks
Jan. 13-14, 20-21, 2023 Sepak Takraw Intramurals Qualified

(Use separate sheet if necessary)

Athlete's Signature over Printed Name

D. Certification on Athlete's Participation

This is to certify that based on our knowledge, the above-mentioned athlete has participated in the lower meets.

Name and Signature of Division Name and Signature of Regional Sports Officer
Meet Name and Signature of Coach
Sports Officer (DSO) (RSO)

Intramurals Christian Dave M. Ranolas

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet Palarong Pambansa

ANTONIO R. PASQUITO JR GEORGE N. WONG, EdD.

(Signature of DSAC over Printed Name) (Signature of RSAC over Printed Name) (Signature of NSAC over Printed Name)

Date: ______________ Date: ______________ Date: ______________

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

Revised as of September 26, 2019

AR (ATHLETE RECORD)

XI
Region

PANABO CITY
Division Latest 1½ x 1½ picture

A. PERSONAL DATA:

Name: PAZ JHON RECK D.

(Last) (First) (M.I.)

Sex: Male Learner Reference Number (LRN) 129800120031 Contact Number N/A
Date of Birth: (mm/dd/yyyy) 05/24/2007 Age: 15 Place of Birth: PANABO CITY
School: A.O. FLOIRENDO NATIONAL HIGH SCHOOL Grade Level 10
Address of School: BRGY. A.O. FLOIRENDO, PANABO CITY
Present Address: BRGY. A.O. FLOIRENDO, PANABO CITY
Parents: JUANITO M. PAZ JR. MERLO D. DENAQUE
Fathers Name Mother/Guardian
Address of Parents/Guardian: BRGY. A.O. FLOIRENDO, PANABO CITY

B. Participation in the previous Palarong Pambansa. Yes ____ No _____ . If Yes, kindly fill up the table below
Year of Participation Sports Event Venue Remarks

C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks
Jan. 13-14, 20-21, 2023 Sepak Takraw Intramurals Qualified

(Use separate sheet if necessary)

Athlete's Signature over Printed Name

D. Certification on Athlete's Participation

This is to certify that based on our knowledge, the above-mentioned athlete has participated in the lower meets.

Name and Signature of Division Name and Signature of Regional Sports Officer
Meet Name and Signature of Coach
Sports Officer (DSO) (RSO)

Intramurals Christian Dave M. Ranolas

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet Palarong Pambansa

ANTONIO R. PASQUITO JR GEORGE N. WONG, EdD.

(Signature of DSAC over Printed Name) (Signature of RSAC over Printed Name) (Signature of NSAC over Printed Name)

Date: ______________ Date: ______________ Date: ______________

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

Revised as of September 26, 2019

AR (ATHLETE RECORD)

XI
Region

PANABO CITY
Latest 1½ x 1½ picture
Division

A. PERSONAL DATA:

Name: CANUBAS SHAINAR CABAN

(Last) (First) (M.I.)

Sex: FEMALE Learner Reference Number (LRN) 129522120053 Contact Number 9489650301
Date of Birth: (mm/dd/yyyy) JULY 26, 2007 Age: 15 Place of Birth: DAVAO CITY
School: A.O. FLOIRENDO NATIONAL HIGH SCHOOL Grade Level 10
Address of School: BARANGAY A.O. FLORENDO PANABO CITY
Present Address: PUROK 11 TONY BOY HOUSING DISTRICT 3
Parents: MICHAL O. CANUBAS ROSMEN O. CANUBAS
Fathers Name Mother/Guardian
Address of Parents/Guardian:

B. Participation in the previous Palarong Pambansa. Yes ____ No _____ . If Yes, kindly fill up the table below
Year of Participation Sports Event Venue Remarks

C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks
JANUARY 14 & 21, 2023 TABLE TENNIS GOLD

(Use separate sheet if necessary)

SHAINAR C. CANUBAS
Athlete's Signature over Printed Name

D. Certification on Athlete's Participation

This is to certify that based on our knowledge, the above-mentioned athlete has participated in the lower meets.

Name and Signature of Division Name and Signature of Regional Sports Officer
Meet Name and Signature of Coach
Sports Officer (DSO) (RSO)

INTRAMURALS 2023 RICHARD P. AMBROCIO

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet Palarong Pambansa

ANTONIO R. PASQUITO JR GEORGE N. WONG, EdD.

(Signature of DSAC over Printed Name) (Signature of RSAC over Printed Name) (Signature of NSAC over Printed Name)

Date: ______________ Date: ______________ Date: ______________

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

Revised as of September 26, 2019

XI
Region

PANABO CITY
Division

A. PERSONAL DATA:

Name: BALABA ASHLEY

(Last) (First)

Sex: FEMALE Learner Reference Number (LRN) 128634140176

Date of Birth: (mm/dd/yyyy) NOVEMBER 03, 2009 Age: 13
School: A.O. FLOIRENDO NATIONAL HIGH SCHOOL
Address of School: BARANGAY A.O. FLORENDO PANABO CITY
Present Address: PACKING 4 PUROK 12 BARANGAY TANGLAW B.E DUJALI
Parents: DANILO C. BALABA
Fathers Name
Address of Parents/Guardian:

B. Participation in the previous Palarong Pambansa. Yes ____ No _____ . If Yes, kindly fill up the table below
Year of Participation Sports Event Venue

C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet
JANUARY 14 & 21, 2023 TABLE TENNIS

(Use separate sheet if necessary)

ASHLEY V. BALABA
 Athlete's Signature over Printed Name

D. Certification on Athlete's Participation

This is to certify that based on our knowledge, the above-mentioned athlete has participated in the lower meets.

Meet Name and Signature of Coach

INTRAMURALS 2023 RICHARD P. AMBROCIO

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet

ANTONIO R. PASQUITO JR GEORGE N. WONG, EdD.

(Signature of DSAC over Printed Name) (Signature of RSAC over Printed Name)

Date: ______________ Date: ______________

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

 AR (ATHLETE RECORD)

Latest 1½ x 1½ picture

VERALLO
(M.I.)

Contact Number 9078585090

Place of Birth: PANABO CITY
Grade Level 8

LI
LIEZLE V. BALABA
Mother/Guardian

y fill up the table below

Venue Remarks

Athletic Meet Remarks

GOLD

ASHLEY V. BALABA
thlete's Signature over Printed Name

rticipated in the lower meets.

Name and Signature of Division Name and Signature of Regional Sports Officer
Sports Officer (DSO) (RSO)

Palarong Pambansa

(Signature of NSAC over Printed Name)

Date: ______________
Revised as of September 26, 2019

XI
Region

PANABO CITY
Division

A. PERSONAL DATA:

Name: SIMBAJON HANNAH JANE

(Last) (First)

Sex: FEMALE Learner Reference Number (LRN) 129789120076

Date of Birth: (mm/dd/yyyy) JULY 17, 2006 Age: 16
School: A.O. FLOIRENDO NATIONAL HIGH SCHOOL
Address of School: BARANGAY A.O. FLORENDO PANABO CITY
Present Address: FARM 1, DAPCO PANABO CITY
Parents: JOENA REY E. SIMBAJON
Fathers Name
Address of Parents/Guardian:

B. Participation in the previous Palarong Pambansa. Yes ____ No _____ . If Yes, kindly fill up the table below
Year of Participation Sports Event Venue

C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet
JANUARY 14 & 21, 2023 TABLE TENNIS

(Use separate sheet if necessary)

HANNAH JANE D. SIMBAJON

 Athlete's Signature over Printed Name

D. Certification on Athlete's Participation

This is to certify that based on our knowledge, the above-mentioned athlete has participated in the lower meets.

Meet Name and Signature of Coach

INTRAMURALS 2023 RICHARD P. AMBROCIO

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet

ANTONIO R. PASQUITO JR GEORGE N. WONG, EdD.

(Signature of DSAC over Printed Name) (Signature of RSAC over Printed Name)

Date: ______________ Date: ______________

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

 AR (ATHLETE RECORD)

Latest 1½ x 1½ picture

NE DONAYRE
(M.I.)

Contact Number 9517933492

Place of Birth: FARM 1, DAPCO PANABO CITY
Grade Level 10

HAIDE D. SIMBAJON
Mother/Guardian

dly fill up the table below

Venue Remarks

Athletic Meet Remarks

SILVER

NNAH JANE D. SIMBAJON

thlete's Signature over Printed Name

articipated in the lower meets.

Name and Signature of Division Name and Signature of Regional Sports Officer
Sports Officer (DSO) (RSO)

Palarong Pambansa

(Signature of NSAC over Printed Name)

Date: ______________
Revised as of September 26, 2019

AR (ATHLETE RECORD)

XI
Region

PANABO CITY
Division Latest 1½ x 1½ picture

A. PERSONAL DATA:

Name: UY PRINCESS RENEGADO

(Last) (First) (M.I.)

Sex: FEMALE Learner Reference Number (LRN) 129789140057 Contact Number 9064876351
Date of Birth: (mm/dd/yyyy) JULY 13, 2009 Age: 13 Place of Birth: APOKON, TAGUM CITY
School: A.O. FLOIRENDO NATIONAL HIGH SCHOOL Grade Level 8
Address of School: BARANGAY A.O. FLORENDO PANABO CITY
Present Address: PUROK 18 BARANGAY A.O. FLOIRENDO PANABO CITY
Parents: BETCHER L. UY EMELYN A. RENEGADO
Fathers Name Mother/Guardian
Address of Parents/Guardian: PUROK 18 BARANGAY A.O. FLOIRENDO PANABO CITY

B. Participation in the previous Palarong Pambansa. Yes ____ No _____ . If Yes, kindly fill up the table below
Year of Participation Sports Event Venue Remarks

C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks
JANUARY 14 & 21, 2023 TABLE TENNIS GOLD

(Use separate sheet if necessary)

PRINCESS R. UY
Athlete's Signature over Printed Name

D. Certification on Athlete's Participation

This is to certify that based on our knowledge, the above-mentioned athlete has participated in the lower meets.

Name and Signature of Division Name and Signature of Regional

Meet Name and Signature of Coach
Sports Officer (DSO) Sports Officer (RSO)

INTRAMURALS 2023 RICHARD P. AMBROCIO

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet Palarong Pambansa

ANTONIO R. PASQUITO JR GEORGE N. WONG, EdD.

(Signature of DSAC over Printed Name) (Signature of RSAC over Printed Name) (Signature of NSAC over Printed Name)

Date: ______________ Date: ______________ Date: ______________

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)