Republic of the Philippines

Department of Education
Region 02(Cagayan Valley)
SCHOOLS DIVISION OFFICE OF ISABELA
Alibagu, City of Ilagan, Isabela 3300

2019 Legislative Area 1 Athletic Meet

Screening Committee

DISTRICT: SAN PABLO Event: VOLLEYBALL (BOYS) LEVEL: AREA

Athlete’s Record PF Coach’s Record

Record

AFFIDAVIT/SWORN STATEMENT
Remarks

CERTIFICATE OF EMPLOYMENT
CERTIFICATE OF ENROLMENT

MEDICAL CERTIFICATE

MEDCAL CERTIFICATE
DENTAL CERTIFICATE
PARENTAL CONSENT

PDS/FORM 212
Number

FORM 137
NSO/PSA
GALLERY

AR-1

PFT

SST
(Alphabetical Order)

Surname Given Name M.I.

1 ACUPIDO JOHN MARK P.
2 AVILA JOHN PAUL D.
3 CURIBANG VIENE-KERYX B.
4 DANAO SEAN BRENT D.
5 FERRER A-JAY T.
6 LUMAUIG CHRISTIAN S.
7 MANSIBANG CHIVAS JOHN M.
MANSIBANG EDIQUE VINCE GIO M.
8
9 SAMUS ROEL JADE B.
10 SORIANO MARK-ANGELO L.
11 TARUN RODOLFO, JR. S.
12 TULIAO VIN LAWRENCE S.

TAPITAN FREDERICK P. COACH

DABO GLADYBEL C. CO-COACH
CHAPERON
Screening Committee:

__________________________ __________________________ __________________________

Member Member Member

__________________________ __________________________

Member Member
 Republic of the Philippines
Department of Education
Region 02(Cagayan Valley)
SCHOOLS DIVISION OFFICE OF ISABELA
Alibagu, City of Ilagan, Isabela 3300

2019 Legislative Area 1 Athletic Meet

Screening Committee

DISTRICT: SAN PABLO Event: TAEKWONDO (GIRLS) LEVEL: AREA

Athlete’s Record PF Coach’s Record

Record

AFFIDAVIT/SWORN STATEMENT
Remarks

CERTIFICATE OF EMPLOYMENT
CERTIFICATE OF ENROLMENT

MEDICAL CERTIFICATE

MEDCAL CERTIFICATE
DENTAL CERTIFICATE
PARENTAL CONSENT

PDS/FORM 212
Number

FORM 137
NSO/PSA
GALLERY

AR-1

PFT

SST
(Alphabetical Order)

Surname Given M.I.

Name
1 DIWAYAN JHANNEL F.
2 FLORES HANNA MAE T.

QUEBRAL ROSIVIC V. COACH

CO-COACH
CHAPERON

Screening Committee:

__________________________ __________________________ __________________________

Member Member Member

__________________________ __________________________

Member Member
 Republic of the Philippines
Department of Education
Region 02(Cagayan Valley)
SCHOOLS DIVISION OFFICE OF ISABELA
Alibagu, City of Ilagan, Isabela 3300

2019 Legislative Area 1 Athletic Meet

Screening Committee

DISTRICT: SAN PABLO Event: BADMINTON (BOYS) LEVEL: AREA

Athlete’s Record PF Coach’s Record

Record

AFFIDAVIT/SWORN STATEMENT
Remarks

CERTIFICATE OF EMPLOYMENT
CERTIFICATE OF ENROLMENT

MEDICAL CERTIFICATE

MEDCAL CERTIFICATE
DENTAL CERTIFICATE
PARENTAL CONSENT

PDS/FORM 212
Number

FORM 137
NSO/PSA
GALLERY

AR-1

PFT

SST
(Alphabetical Order)

Surname Given Name M.I.

1 BAQUIRAN FRANK BRIAN B.
2 DE LUNA RYAN DAVE T.
3 MANALO MANOLITO, JR P.
4 PARAGGUA JOHN LESTER G.

DE LUNA FRECY T. COACH

CO-COACH
CHAPERON

Screening Committee:

__________________________ __________________________ __________________________

Member Member Member

__________________________ __________________________

Member Member
 Republic of the Philippines
Department of Education
Region 02(Cagayan Valley)
SCHOOLS DIVISION OFFICE OF ISABELA
Alibagu, City of Ilagan, Isabela 3300

2019 Legislative Area 1 Athletic Meet

Screening Committee

DISTRICT: SAN PABLO Event: TAEKWONDO (BOYS) LEVEL: AREA

Athlete’s Record PF Coach’s Record

Record

AFFIDAVIT/SWORN STATEMENT
Remarks

CERTIFICATE OF EMPLOYMENT
CERTIFICATE OF ENROLMENT

MEDICAL CERTIFICATE

MEDCAL CERTIFICATE
DENTAL CERTIFICATE
PARENTAL CONSENT

PDS/FORM 212
Number

FORM 137
NSO/PSA
GALLERY

AR-1

PFT

SST
(Alphabetical Order)

Surname Given Name M.I.

1 TAGUBA JAHLEEL ANDREI B.
2
3
4
5
6
7
8
9
10
11
12

BAUI BELINDA C. COACH

CO-COACH
CHAPERON
Screening Committee:

__________________________ __________________________ __________________________

Member Member Member

__________________________ __________________________

Member Member