TFSS Form No.

AR 001

AR-I (ATHLETE RECORD)

VI Region

ILOILO Latest 1 x 1 picture Division

A. PERSONAL DATA: Name:

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

Sex: Age: Place of Birth:

Date of Birth: (mm/dd/yy) School: Address of School: Home Address: Parents:

CHILDREN'S INTEGRATED SCHOOL OF ALTA TIERRA, INC. PHASE V, ALTA TIERRA VILLAGE, JARO, ILOILO CITY

Fathers Name

Mother/Guardian

Address of Parents:

B. Athlete's Participation in Local/International Competition Inclusive Dates Sports Event Athletic Meet

Remarks

(Use separate sheet if necessary)

Athlete's Signature

C. Athlete's Participation This is to certify that based on our knowledge the above-mentioned athlete has participated in the lower meets.
Athletic meet Coaches

Division PESS Supervisor/s

(Use separate sheet if necessary)

Screened by: Division Meet

(Signature over Printed Name)

Regional Meet
(Signature over Printed Name)

Date:

Date:

dian

Remarks

upervisor/s

d Name)