TFSS Form No.

AR 001

AR-I (ATHLETE RECORD)

1
Region

Latest 1 x 1 picture

LA UNION
Division

A. PERSONAL DATA:
Name:

Sex:
(Last)

Date of Birth: (mm/dd/yy)

School:
Address of School:

(First)

Age:

(M.I.)

Place of Birth:

Home Address:
Parents:
Fathers Name

Mother/Guardian

Address of Parents:
B. Athlete's Participation in Local/International Competition
Athletic Meet
Inclusive Dates
Sports Event

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

Division PESS Supervisor/s

Coaches

SALVACION G. FLORES
SALVACION G. FLORES
SALVACION G. FLORES
SALVACION G. FLORES

(Use separate sheet if necessary)

Screened by:
Division Meet

Regional Meet

(Signature over Printed Name)

Date:

(Signature over Printed Name)

Date: