REPUBLIC OF THE PHILIPPINES

15 78
Province of La Union
Municipality of Agoo
OFFICE OF THE MUNICIPAL MAYOR

AGOO RUN FOR CURE 2023P

October 7, 2023 || Agoo Farmers’ Building to Cabaguan, San Julian Norte

AGENCY/ BARANGAY/ SCHOOL: BARANGAY SAN AGUSTIN EAST

FOCAL PERSON: ROMEO L. TAVARES

CONTACT NUMBER (preferably mobile): 09205271464

LIST OF PARTICIPANTS (fill-up all columns):

COMPLETE NAME CONTACT NUMBER T-SHIRT SIZE

(First Name, Middle Initial, Last Name) (Mobile Number) (XS, S, M, L, XL, XXL)

1. ROMEO L. TAVARES 09205271464

2. JOSE A. VENTURA JR. 09460447382

3. HIALRIO V. HALOG 09639932502

4. RYAN L. SAMSON 09999268814

5. GRACE V. DUCO 09063835246

6. NITA P. ROMERO 09272137492

7. FELICIDAD A. CAMARILLO 09086899377

8. LOLITA A. ADRIANO 09454993496

9. ADRIAN C. SELIN 09926860940

10. BEATRIZ S. BALLESTEROS 09292169004

11. JESSICA A. FRIAS 09935082404

(Please use separate sheet, if necessary.)

___________________________

Agoo Farmers’ Multi-Purpose Building, Cases Boulevard, Sta. Barbara, Agoo, La Union
E-mail: lgu_agoo@yahoo.com, Telefax No.: (072) 607-2184
 REPUBLIC OF THE PHILIPPINES
15 78
Province of La Union
Municipality of Agoo
OFFICE OF THE MUNICIPAL MAYOR

Signature over Printed Name of Authorized

Representative

Agoo Farmers’ Multi-Purpose Building, Cases Boulevard, Sta. Barbara, Agoo, La Union
E-mail: lgu_agoo@yahoo.com, Telefax No.: (072) 607-2184