Revised as of April 3, 2023

AR (ATHLETE RECORD)
III
Region

Nueva Ecija
Latest 1½ x 1½ picture
Division

A. PERSONAL DATA:

Name: Miranda Yuan Kyle E.

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

Sex: Male Learner Reference Number (LRN) 419027150362 Contact Number 9936149366

Date of Birth: (mm/dd/yyyy) 05/10/2007 Age: 16 Place of Birth: Cabiao, Nueva Ecija
School: Little Child Jesus Christian Academy Grade Level 10
Address of School: Polilio, Cabiao, Nueva Ecija
Present Address: Puror 3, Sta. Rita, Cabiao, Nueva Ecija
Parents: Walter Miranda Renila E. Miranda
Fathers Name Mother/Guardian
Address of Parents/Guardian: Puror 3, Sta. Rita, Cabiao, Nueva Ecija

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B. Participation in the previous Palarong Pambansa. Yes ____ No _____ . If Yes, kindly fill up the table below
Year of Participation Sports Event Venue Remarks

C. Athlete's Participation in the Lower Meets (For the Current School Year)
Inclusive Dates Sports Event Athletic Meet Remarks

November 11, 2023 Badminton Secondary Boys District Meet Gold

December 08, 2023 Badminton Secondary Boys Dual Meet Gold

(Use separate sheet if necessary)

YUAN KYLE E. MIRANDA

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 been a member of a school based club and has
participated in the lower meets.

Name and Signature of Division Name and Signature of

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

District Meet 2023 MICHELLE L. MUYOT

Dual Meet 2023 MICHELLE L. MUYOT
JOEL V. CRUZ

(Use separate sheet if necessary)

Screened by:
Division Meet Regional Meet Palarong Pambansa

RONYLA S. RAMY
(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)