Revised as of February 2024
CACR (COACH /ASST.COACH RECORD)
VIII
Region
ORMOC CITY
Division
Latest 1½ x 1½ picture
A. PERSONAL DATA:
Name: YBAÑEZ CARL KEVIN VAL E.
(Last) (First) (M.I.)
Sex: MALE Mobile Phone Number: 9273731586
Date of Birth: (mm/dd/yy) 11/11/1994 Age: 30 Place of Birth: ORMOC CITY, LEYTE
School: LIBERTY INTEGRATED SCHOOL Employee Number: 6309963
Current Position: TEACHER I Years in Service: 2 YEARS
Address of School: BRGY. LIBERTY, ORMOC CITY, LEYTE
Present Address: BRGY. ALEGRIA, ORMOC CITY, LEYTE
In Case of Emergency
Please Contact: MIA GALLEGOS Contact Number: 9309513571
B. Educational Qualifications:
Course (College/Post
School Year Graduated Credits Earned Awards Received
Graduate)
BSED-MAPEH EASTERN VISAYAS STATE UNIVERSITY 2018
C. Sports Training Attended for the last three (3) years
Title of Sports Training Date of Training No. of Hours Conducted by
DIVISION REFRESHER COURSE NOVEMBER 21-23 24 DIVISION OF ORMOC
D. Sports Track Record/Experience
Athletic Meet Attended Inclusive Dates Event Awards Received
District Meet OCTOBER 24-25, 2024 CHESS
Prepared by: Attested by: Verified by:
CARL KEVIN VAL E. YBAÑEZ
(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)
