AR-I (ATHLETE RECORD)

REGION XI
Region
Latest 1½ x 1½
SCHOOLS DIVISION OF DIGOS CITY picture
Division

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
Division/Provincial Meet EPPIE GRACE E. PRESTO
Regional Meet EPPIE GRACE E. PRESTO
Palarong Pambansa EPPIE GRACE E. PRESTO

(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