SCUAA Form 2

REGIONAL SCUAA GAMES 2017 OFFICIAL ENTRY FORM AND GALLERY OF

December 4-9, 2017 at University of Antique Type here
Page 1of 2
(Event)
Date of Screening: (_____________)

REGION: CARLOS HILADO MEMORIAL STATE COLLEGE Category Type here

ATHLETE ATHLETE ATHLETE ATHLETE ATHLETE ATHLETE

School Seal Recent Scanned Recent Scanned Recent Scanned Recent Scanned Recent Scanned Recent Scanned
Picture Picture Picture Picture Picture Picture
Here..

Name Type here Type here Type here Type here Type here Type here
Date of Birth Type here Type here Type here Type here Type here Type here
Course & Year Type here Type here Type here Type here Type here Type here
School Type here Type here Type here Type here Type here Type here

ATHLETE ATHLETE ATHLETE ATHLETE ATHLETE ATHLETE

Recent Scanned Recent Scanned Recent Scanned Recent Scanned Recent Scanned Recent Scanned
Picture Picture Picture Picture Picture Picture

Name Type here Type here Type here Type here Type here Type here
Date of Birth Type here Type here Type here Type here Type here Type here
Course & Year Type here Type here Type here Type here Type here Type here
School Type here Type here Type here Type here Type here Type here
 SCUAA Form 2
REGIONAL SCUAA GAMES 2017 OFFICIAL ENTRY FORM AND GALLERY OF
December 4-9, 2017 at University of Antique Type here
Page 2of 2
(Event)
Date of Screening: (please refer to the SCUAA National
Games Manual)
REGION: CARLOS HILADO MEMORIAL STATE COLLEGE Category Type here

ATHLETE ATHLETE ATHLETE ATHLETE ATHLETE ATHLETE

School Seal Recent Scanned Recent Scanned Recent Scanned Recent Scanned Recent Scanned Recent Scanned
Picture Picture Picture Picture Picture Picture
Here..

Name Type here Type here Type here Type here Type here Type here
Date of Birth Type here Type here Type here Type here Type here Type here
Course & Year Type here Type here Type here Type here Type here Type here
School Type here Type here Type here Type here Type here Type here
Eligibility Requirements:
COACH ASST. COACH CHAPERON
1.) Official Transcript of REGIONAL SCUAA
Records (OTR) with: Games 2017
a.) complete scholastic
record of athlete.
Recent Scanned Recent Scanned Recent Scanned Recent Scanned b.) subjects and grades
of 1st Sem, SY 2017-
Picture Picture Picture Picture University Seal
2018.
c.) subjects enrolled for
2nd Sem, SY 2017-
2018
e.) scanned Picture of
Name Type here Type here Type here Type here student
Age Type here Type here Type here Type here f.) School Dry Seal
GERTRUDES ANASTACIA D. LOPEZ
Contact no#/ Mobile no# Type here Type here Type here Type here 2.) SCUAA Games Form ________________
Numbers: 1, 2 & 3. SUC SPORTS DIRECTOR/
3.) NSO Birth Certificate COORDINATOR
Email Address Type here Type here Type here Type here 4.) CMO. 63-Certificate of
Compliance from HEI.