REPUBLIC OF THE PHILIPPINES

15 78
Province of La Union
Municipality of Agoo
OFFICE OF THE MUNICIPAL MAYOR

AGOO RUN FOR CURE 2023

October 7, 2023 || Agoo Farmers’ Building to Cabaguan, San Julian Norte

AGENCY/ BARANGAY/ SCHOOL: BARANGAY SAN AGUSTIN EAST

FOCAL PERSON: ROMEO L. TAVARES

CONTACT NUMBER (preferably mobile): 09205271464

LIST OF PARTICIPANTS (fill-up all columns):

COMPLETE NAME CONTACT NUMBER T-SHIRT SIZE

(First Name, Middle Initial, Last Name) (Mobile Number) (XS, S, M, L, XL, XXL)

1. ROMEO L. TAVARES 09205271464 L

2. JOSE A. VENTURA JR. 09460447382 L

3. HILARIO V. HALOG 09639932502 M

4. RYAN L. SAMSON 09999268814 XXL

5. GRACE V. DUCO 09063835246 L

6. NITA P. ROMERO 09272137492 M

7. FELICIDAD A. CAMARILLO 09086899377 M

8. LOLITA A. ADRIANO 09454993496 L

9. ADRIAN C. SELIN 09926860940 M

10. BEATRIZ BALLESTEROS 09292169004 M

11. JESSICA A. FRIAS 09777539800 S

(Please use separate sheet, if necessary.)

__ROMEO L. TAVARES_____________

Agoo Farmers’ Multi-Purpose Building, Cases Boulevard, Sta. Barbara, Agoo, La Union
E-mail: lgu_agoo@yahoo.com, Telefax No.: (072) 607-2184
 REPUBLIC OF THE PHILIPPINES
15 78
Province of La Union
Municipality of Agoo
OFFICE OF THE MUNICIPAL MAYOR

Signature over Printed Name of Authorized

Representative

Agoo Farmers’ Multi-Purpose Building, Cases Boulevard, Sta. Barbara, Agoo, La Union
E-mail: lgu_agoo@yahoo.com, Telefax No.: (072) 607-2184