Revised as of September 26, 2019

AR (ATHLETE RECORD)
II
Region

TUGUEGARAO CITY
Latest 1½ x 1½ picture
Division

A. PERSONAL DATA:

Name: CARODAN ISABELLE M

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

Sex: FEMALE Learner Reference Number (LRN) 104402140069 Contact Number Place of Birth:
Indicate the
Date of Birth: (mm/dd/yyyy) 07/15/2009 Age: 10 Place of Birth: TUGUEGARAO CITY Municipality/Provin
School: CATAGGAMAN ELEMENTARY SCHOOL Grade Level V ity
Address of School: CATAGGAMAN VIEJO, TUGUEGARAO CITY
Present Address: CATAGGAMAN PARDO, TUGUEGARAO CITY
Parents: JACKSON G. CARODAN MARY GRACE M. CARODAN
Fathers Name Mother/Guardian
Address of Parents/Guardian: CATAGGAMAN PARDO, TUGUEGARAO 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
Rema
Gold,
Runn

Rema
Gold,
Rema
Runn
Gold,
Runn
C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks
AUG. 22, 2019 BADMINTON INTRAMS Remarks
Gold,
RemaSil
Remarks
Runner-
Gold,
Gold, Sil
Runn
Runner-
Rema
Gold,
Runn
(Use separate sheet if necessary)

ISABELLE M. CARODAN
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 Name and Signature of

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

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet Palarong Pambansa

(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)
 ace of Birth:
ndicate the
unicipality/Province/C
y

Remarks:
Gold, Silver. Bronze,
Runner-Up

Remarks:
Gold, Silver. Bronze,
Remarks:
Runner-Up
Gold, Silver. Bronze,
Runner-Up

Remarks:
Gold, Silver. Bronze,
Remarks:
Remarks:
Runner-Up
Gold, Silver. Bronze,
Gold, Silver. Bronze,
Runner-Up
Runner-Up
Remarks:
Gold, Silver. Bronze,
Runner-Up
Revised as of September 26, 2019

AR (ATHLETE RECORD)
II
Region

TUGUEGARAO CITY
Latest 1½ x 1½ picture
Division

A. PERSONAL DATA:

Name: MAMING KEITH NICOLE A.

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

Sex: FEMALE Learner Reference Number (LRN) 104402130206 Contact Number Place of Birth:
Indicate the
Date of Birth: (mm/dd/yyyy) 07/25/2008 Age: 11 Place of Birth: TUGUEGARAO CITY Municipality/Provin
School: CATAGGAMAN ELEMENTARY SCHOOL Grade Level VI ity
Address of School: CATAGGAMAN VIEJO, TUGUEGARAO CITY
Present Address: CATAGGAMAN VIEJO, TUGUEGARAO CITY
Parents: JANETH C. ANDAL
Fathers Name Mother/Guardian
Address of Parents/Guardian: CATAGGAMAN VIEJO, TUGUEGARAO 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
Rema
Gold,
Runn

Rema
Gold,
Rema
Runn
Gold,
Runn
C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks
AUG. 22, 2019 BADMINTON INTRAMS Remark
Gold,
RemaSil
Remark
Runner-
Gold,
Gold, Sil
Runn
Runner-
Rema
Gold,
Runn
(Use separate sheet if necessary)

KEITH NICOLE A. MAMING

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 Name and Signature of

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

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet Palarong Pambansa

(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)
 ace of Birth:
ndicate the
unicipality/Province/C
y

Remarks:
Gold, Silver. Bronze,
Runner-Up

Remarks:
Gold, Silver. Bronze,
Remarks:
Runner-Up
Gold, Silver. Bronze,
Runner-Up

Remarks:
Gold, Silver. Bronze,
Remarks:
Remarks:
Runner-Up
Gold, Silver. Bronze,
Gold, Silver. Bronze,
Runner-Up
Runner-Up
Remarks:
Gold, Silver. Bronze,
Runner-Up
Revised as of September 26, 2019

AR (ATHLETE RECORD)
II
Region

TUGUEGARAO CITY
Latest 1½ x 1½ picture
Division

A. PERSONAL DATA:

Name: SALAS IRISH ANGEL A.

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

Sex: FEMALE Learner Reference Number (LRN) 104402130091 Contact Number Place of Birth:
Indicate the
Date of Birth: (mm/dd/yyyy) 04/15/2008 Age: 11 Place of Birth: TUGUEGARAO CITY Municipality/Provin
School: CATAGGAMAN ELEMENTARY SCHOOL Grade Level VI ity
Address of School: CATAGGAMAN VIEJO, TUGUEGARAO CITY
Present Address: CATAGGAMAN VIEJO, TUGUEGARAO CITY
Parents: ARNEL C. SALAS ALMA A. SALAS
Fathers Name Mother/Guardian
Address of Parents/Guardian: CATAGGAMAN VIEJO, TUGUEGARAO 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
Rema
Gold,
Runn

Rema
Gold,
Rema
Runn
Gold,
Runn
C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks
AUG. 22, 2019 BADMINTON INTRAMS Remark
Gold,
RemaSil
Remark
Runner-
Gold,
Gold, Sil
Runn
Runner-
Rema
Gold,
Runn
(Use separate sheet if necessary)

IRISH ANGEL A. SALAS

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 Name and Signature of

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

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet Palarong Pambansa

(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)
 ace of Birth:
ndicate the
unicipality/Province/C
y

Remarks:
Gold, Silver. Bronze,
Runner-Up

Remarks:
Gold, Silver. Bronze,
Remarks:
Runner-Up
Gold, Silver. Bronze,
Runner-Up

Remarks:
Gold, Silver. Bronze,
Remarks:
Remarks:
Runner-Up
Gold, Silver. Bronze,
Gold, Silver. Bronze,
Runner-Up
Runner-Up
Remarks:
Gold, Silver. Bronze,
Runner-Up
Revised as of September 26, 2019

AR (ATHLETE RECORD)
II
Region

TUGUEGARAO CITY
Latest 1½ x 1½ picture
Division

A. PERSONAL DATA:

Name: DULIN VALERIE B.

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

Sex: FEMALE Learner Reference Number (LRN) 104402130269 Contact Number Place of Birth:
Indicate the
Date of Birth: (mm/dd/yyyy) 12/29/2008 Age: 10 Place of Birth: TUGUEGARAO CITY Municipality/Provin
School: CATAGGAMAN ELEMENTARY SCHOOL Grade Level VI ity
Address of School: CATAGGAMAN VIEJO, TUGUEGARAO CITY
Present Address: CATAGGAMAN VIEJO, TUGUEGARAO CITY
Parents: JUNAR C. DULIN ANJELIE B. DULIN
Fathers Name Mother/Guardian
Address of Parents/Guardian: CATAGGAMAN VIEJO, TUGUEGARAO 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
Rema
Gold,
Runn

Rema
Gold,
Rema
Runn
Gold,
Runn
C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks
AUG. 22, 2019 BADMINTON INTRAMS Remark
Gold,
RemaSil
Remark
Runner-
Gold,
Gold, Sil
Runn
Runner-
Rema
Gold,
Runn
(Use separate sheet if necessary)

VALERIE B. DULIN
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 Name and Signature of

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

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet Palarong Pambansa

(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)
 ace of Birth:
ndicate the
unicipality/Province/C
y

Remarks:
Gold, Silver. Bronze,
Runner-Up

Remarks:
Gold, Silver. Bronze,
Remarks:
Runner-Up
Gold, Silver. Bronze,
Runner-Up

Remarks:
Gold, Silver. Bronze,
Remarks:
Remarks:
Runner-Up
Gold, Silver. Bronze,
Gold, Silver. Bronze,
Runner-Up
Runner-Up
Remarks:
Gold, Silver. Bronze,
Runner-Up
Revised as of September 26, 2019

AR (ATHLETE RECORD)
II
Region

TUGUEGARAO CITY
Latest 1½ x 1½ picture
Division

A. PERSONAL DATA:

Name: GUZMAN ALEXANDER V.

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

Sex: MALE Learner Reference Number (LRN) 104402140108 Contact Number Place of Birth:
Indicate the
Date of Birth: (mm/dd/yyyy) 06/24/2009 Age: 11 Place of Birth: TUGUEGARAO CITY Municipality/Provin
School: CATAGGAMAN ELEMENTARY SCHOOL Grade Level V ity
Address of School: CATAGGAMAN VIEJO, TUGUEGARAO CITY
Present Address: CATAGGAMAN NUEVO, TUGUEGARAO CITY
Parents: ROMEL GUZMAN BERNADETTE V. GUZMAN
Fathers Name Mother/Guardian
Address of Parents/Guardian: CATAGGAMAN NUEVO, TUGUEGARAO 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
Rema
Gold,
Runn

Rema
Gold,
Rema
Runn
Gold,
Runn
C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks
AUG. 22, 2019 BADMINTON INTRAMS Remark
Gold,
RemaSil
Remark
Runner-
Gold,
Gold, Sil
Runn
Runner-
Rema
Gold,
Runn
(Use separate sheet if necessary)

ALEXANDER V. GUZMAN
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 Name and Signature of

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

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet Palarong Pambansa

(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)
 ace of Birth:
ndicate the
unicipality/Province/C
y

Remarks:
Gold, Silver. Bronze,
Runner-Up

Remarks:
Gold, Silver. Bronze,
Remarks:
Runner-Up
Gold, Silver. Bronze,
Runner-Up

Remarks:
Gold, Silver. Bronze,
Remarks:
Remarks:
Runner-Up
Gold, Silver. Bronze,
Gold, Silver. Bronze,
Runner-Up
Runner-Up
Remarks:
Gold, Silver. Bronze,
Runner-Up
Revised as of September 26, 2019

AR (ATHLETE RECORD)
II
Region

TUGUEGARAO CITY
Latest 1½ x 1½ picture
Division

A. PERSONAL DATA:

Name: ADDUCUL CHRISTIAN JAY B

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

Sex: MALE Learner Reference Number (LRN) 109396140791 Contact Number Place of Birth:
Indicate the
Date of Birth: (mm/dd/yyyy) 12/21/2007 Age: 11 Place of Birth: TUGUEGARAO CITY Municipality/Provin
School: CATAGGAMAN ELEMENTARY SCHOOL Grade Level VI ity
Address of School: CATAGGAMAN VIEJO, TUGUEGARAO CITY
Present Address: CATAGGAMAN NUEVO, TUGUEGARAO CITY
Parents: RONALD M. ADDUCUL JR. MARY-ANNE B. ADDUCUL
Fathers Name Mother/Guardian
Address of Parents/Guardian: CATAGGAMAN NUEVO, TUGUEGARAO 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
Rema
Gold,
Runn

Rema
Gold,
Rema
Runn
Gold,
Runn
C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks
AUG. 22, 2019 BADMINTON INTRAMS Remark
Gold,
RemaSil
Remark
Runner-
Gold,
Gold, Sil
Runn
Runner-
Rema
Gold,
Runn
(Use separate sheet if necessary)

CHRISTIAN JAY B. ADDUCUL

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 Name and Signature of

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

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet Palarong Pambansa

(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)
 ace of Birth:
ndicate the
unicipality/Province/C
y

Remarks:
Gold, Silver. Bronze,
Runner-Up

Remarks:
Gold, Silver. Bronze,
Remarks:
Runner-Up
Gold, Silver. Bronze,
Runner-Up

Remarks:
Gold, Silver. Bronze,
Remarks:
Remarks:
Runner-Up
Gold, Silver. Bronze,
Gold, Silver. Bronze,
Runner-Up
Runner-Up
Remarks:
Gold, Silver. Bronze,
Runner-Up
Revised as of September 26, 2019

AR (ATHLETE RECORD)
II
Region

TUGUEGARAO CITY
Latest 1½ x 1½ picture
Division

A. PERSONAL DATA:

Name: LAUIGAN KURTZEN MCREI S

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

Sex: MALE Learner Reference Number (LRN) 104402130056 Contact Number Place of Birth:
Indicate the
Date of Birth: (mm/dd/yyyy) 07/18/2008 Age: 12 Place of Birth: TUGUEGARAO CITY Municipality/Provin
School: CATAGGAMAN ELEMENTARY SCHOOL Grade Level VI ity
Address of School: CATAGGAMAN VIEJO, TUGUEGARAO CITY
Present Address: CATAGGAMAN NUEVO, TUGUEGARAO CITY
Parents: GALEN S. LAUIGAN KATRINA ROSE S. LAUIGAN
Fathers Name Mother/Guardian
Address of Parents/Guardian: CATAGGAMAN NUEVO, TUGUEGARAO 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
Rema
Gold,
Runn

Rema
Gold,
Rema
Runn
Gold,
Runn
C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks
AUG. 22, 2019 BADMINTON INTRAMS Remark
Gold,
RemaSil
Remark
Runner-
Gold,
Gold, Sil
Runn
Runner-
Rema
Gold,
Runn
(Use separate sheet if necessary)

KURTZEN MCREI S. LAUIGAN

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 Name and Signature of

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

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet Palarong Pambansa

(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)
 ace of Birth:
ndicate the
unicipality/Province/C
y

Remarks:
Gold, Silver. Bronze,
Runner-Up

Remarks:
Gold, Silver. Bronze,
Remarks:
Runner-Up
Gold, Silver. Bronze,
Runner-Up

Remarks:
Gold, Silver. Bronze,
Remarks:
Remarks:
Runner-Up
Gold, Silver. Bronze,
Gold, Silver. Bronze,
Runner-Up
Runner-Up
Remarks:
Gold, Silver. Bronze,
Runner-Up
Revised as of September 26, 2019

AR (ATHLETE RECORD)
II
Region

TUGUEGARAO CITY
Latest 1½ x 1½ picture
Division

A. PERSONAL DATA:

Name: GUZMAN PATRICK XYRUS C.

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

Sex: MALE Learner Reference Number (LRN) 104402140030 Contact Number Place of Birth:
Indicate the
Date of Birth: (mm/dd/yyyy) 04/24/2008 Age: 12 Place of Birth: TUGUEGARAO CITY Municipality/Provin
School: CATAGGAMAN ELEMENTARY SCHOOL Grade Level VI ity
Address of School: CATAGGAMAN VIEJO, TUGUEGARAO CITY
Present Address: CATAGGAMAN NUEVO, TUGUEGARAO CITY
Parents: ROLAN L. GUZMAN MINERVA KAREN C. GUZMAN
Fathers Name Mother/Guardian
Address of Parents/Guardian: CATAGGAMAN NUEVO, TUGUEGARAO 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
Rema
Gold,
Runn

Rema
Gold,
Rema
Runn
Gold,
Runn
C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks
AUG. 22, 2019 BADMINTON INTRAMS Remark
Gold,
RemaSil
Remark
Runner-
Gold,
Gold, Sil
Runn
Runner-
Rema
Gold,
Runn
(Use separate sheet if necessary)

PATRICK XYRUS C. GUZMAN

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 Name and Signature of

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

(Use separate sheet if necessary)

Screened by:

Division Meet Regional Meet Palarong Pambansa

(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)
 ace of Birth:
ndicate the
unicipality/Province/C
y

Remarks:
Gold, Silver. Bronze,
Runner-Up

Remarks:
Gold, Silver. Bronze,
Remarks:
Runner-Up
Gold, Silver. Bronze,
Runner-Up

Remarks:
Gold, Silver. Bronze,
Remarks:
Remarks:
Runner-Up
Gold, Silver. Bronze,
Gold, Silver. Bronze,
Runner-Up
Runner-Up
Remarks:
Gold, Silver. Bronze,
Runner-Up