CITY OF NAGA

DIVISION
Secondary
LEVEL

Swimming- Boys
EVENT

CERTIFICATE OF EMPLOYMENT
AFFIDAVIT / SWORN STATEMENT
PERSONAL DATA SHEET
MEDICAL CERTIFICATE
COACH CERTIFICATE OF TRAINING ASST. COACH
CERTIFICATE OF SPORTS MEMBERSHIP
CERTIFICATE OF SPORTS RECOGNITION
DULY NOTARIZED CONTRACT OF SERVICE

Repollo, Jeraldine S. NAME

ANTONIO R. LAPIZ NATIONAL HIGH SHOOL SCHOOL

13-Nov-91 DATE OF BIRTH

0905-644-0510 CONTACT NUMBER
CERTIFICATE OF EMPLOYMENT
AFFIDAVIT / SWORN STATEMENT
PERSONAL DATA SHEET
MEDICAL CERTIFICATE
CHAPERON
CERTIFICATE OF TRAINING
CERTIFICATE OF SPORTS MEMBERSHIP
CERTIFICATE OF SPORTS RECOGNITION
DULY NOTARIZED CONTRACT OF SERVICE
NAME

SCHOOL

CONTACT NUMBER

AR - 1
NSO
FORM - 137
CERTIFICATE OF ENROLMENT
ATHLETE1 CERTIFICATE OF COMPLETION ATHLETE 3
PARENTAL CONSENT
MEDICAL CERTIFICATE
DENTAL CERTIFICATE
INTERVIEWED
Espinosa, Jason C. NAME OF ATHLETE
June 2, 2006 DATE OF BIRTH
ANTONIO R. LAPIZ NATIONAL HIGH SCHOOL SCHOOL
11917110045 LEARNERS REFERENCE NUMBER (LRN)
0935-553-7552 CONTACT NUMBER

AR - 1
NSO

FORM - 137
CERTIFICATE OF ENROLMENT
ATHLETE 2 CERTIFICATE OF COMPLETION ATHLETE 4
PARENTAL CONSENT
MEDICAL CERTIFICATE

DENTAL CERTIFICATE
INTERVIEWED
Espinosa, Jose Joemare Jr. C. NAME OF ATHLETE
June 23, 2004 DATE OF BIRTH
ANTONIO R. LAPIZ NATIONAL HIGH SCHOOL SCHOOL
119517100024 LEARNERS REFERENCE NUMBER (LRN)
0935-553-7552 CONTACT NUMBER
 CITY OF NAGA
DIVISION
Secondary
LEVEL

0
EVENT
AR - 1
NSO
FORM - 137
CERTIFICATE OF ENROLMENT

ATHLETE 5 CERTIFICATE OF COMPLETION ATHLETE 9

PARENTAL CONSENT
MEDICAL CERTIFICATE
DENTAL CERTIFICATE
INTERVIEWED
0 NAME OF ATHLETE
December 30, 1899 DATE OF BIRTH December 30, 1899
ANTONIO R. LAPIZ NATIONAL HIGH SCHOOL SCHOOL ANTONIO R. LAPIZ NATIONAL HIGH SCHOOL

0 LEARNERS REFERENCE NUMBER (LRN) 0

0 CONTACT NUMBER 0
AR - 1
NSO
FORM - 137
CERTIFICATE OF ENROLMENT
ATHLETE 6 CERTIFICATE OF COMPLETION ATHLETE 10
PARENTAL CONSENT
MEDICAL CERTIFICATE
DENTAL CERTIFICATE
INTERVIEWED
0 NAME OF ATHLETE
December 30, 1899 DATE OF BIRTH December 30, 1899
ANTONIO R. LAPIZ NATIONAL HIGH SCHOOL SCHOOL ANTONIO R. LAPIZ NATIONAL HIGH SCHOOL

0 LEARNERS REFERENCE NUMBER (LRN) 0

0 CONTACT NUMBER 0
AR - 1
NSO
FORM - 137
CERTIFICATE OF ENROLMENT
ATHLETE 7 CERTIFICATE OF COMPLETION ATHLETE 11
PARENTAL CONSENT
MEDICAL CERTIFICATE
DENTAL CERTIFICATE
INTERVIEWED
0 NAME OF ATHLETE
December 30, 1899 DATE OF BIRTH December 30, 1899
ANTONIO R. LAPIZ NATIONAL HIGH SCHOOL SCHOOL ANTONIO R. LAPIZ NATIONAL HIGH SCHOOL

0 LEARNERS REFERENCE NUMBER (LRN) 0

0 CONTACT NUMBER 0
AR - 1
NSO
FORM - 137
CERTIFICATE OF ENROLMENT
ATHLETE 8 CERTIFICATE OF COMPLETION ATHLETE 12
PARENTAL CONSENT
MEDICAL CERTIFICATE
DENTAL CERTIFICATE
INTERVIEWED
0 NAME OF ATHLETE
December 30, 1899 DATE OF BIRTH December 30, 1899
ANTONIO R. LAPIZ NATIONAL HIGH SCHOOL SCHOOL ANTONIO R. LAPIZ NATIONAL HIGH SCHOOL

0 LEARNERS REFERENCE NUMBER (LRN) 0

0 CONTACT NUMBER 0