Revised as of April 3, 2023

CACR (COACH /ASST.COACH, CHAPERON RECORD)

III - CENTRAL LUZON

Region

BULACAN
Division Latest 1½ x 1½ picture

A. PERSONAL DATA:

Name: LAPIRA MARIA JOSEFA B.

(Last) (First) (M.I.)
Sex: FEMALE Mobile Phone Number: 9684636808

Date of Birth: (mm/dd/yy) 03/19/1991 Age: 32 Place of Birth: APALIT, PAMPANGA

School: CALUMPIT CENTRAL SCHOOL Employee Number: 4159818

Current Position: SPED TEACHER I Years in Service: 10 YEARS

Address of School: CORAZON CALUMPIT BULACAN
Present Address: BLOCK 77 LOT 14 PHASE 1 PERGOLA STREET LA RESIDENCIA SERGIO BAYAN, CALUMPIT, BULACAN
In Case of Emergency
Please Contact: DANILO M. LAPIRA JR. Contact Number: 9991911974

B. Educational Qualifications:
Course (College/Post
School Year Graduated Credits Earned Awards Received
Graduate)
BEED- SPED UNIVERSITY OF THE EAST 2011 GRADUATED N/A

C. Sports Training Attended for the last three (3) years

Title of Sports Training Date of Training No. of Hours Conducted by

NATIONAL REFRSHER COURSE FOR DEPED MAY 25-27, 2022 24 DEPARTMENT OF EDUCATION
PARAGAMES COACHES
SPORTS CLINIC ACCREDITATION FOR
TEACHER- COACHES OF COMBATIVE AND NON-
COMBATIVE SPORTS SPECIAL EVENTS
MARCH 13-15, 2023 24 DEPARTMENT OF EDUCATION
(PARAGAMES)

D. Sports Track Record/Experience

Athletic Meet Attended Inclusive Dates Event Awards Received
SCHOOL MEET DECEMBER 01, 2023 PARAGAMES- ATHLETICS FIRST
DISTRICT MEET JANUARY 08-09, 2024 PARAGAMES- ATHLETICS FIRST
EDDIS MEET JANUARY 31, 2024 PARAGAMES- ATHLETICS FIRST

Prepared by: Attested by: Verified by:

MARIA JOSEFA B. LAPIRA ANNE P. CASTILLO, PhD. MA. RITA S. BUFA

(Coach /Asst. Coach Signature over Printed Name) (Division Sports Officer Signature over Printed Name) (Division AO/SDS Signature over Printed Name)

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 (Division, Region, Palarong Pambansa)