| No | Nama Lengkap | Cabor | Provinsi | No. Pelatih |
| 1 | BIMA PUTRA EKA BUDI K.W | MENEMBAK | NTB | 2120005557 |
| 2 | I PUTU SUMERTAYASA | BULUTANGKIS | NTB | 2120005558 |
| 3 | M. HANAGFI | KARATE | NTB | 2120005559 |
| 4 | WAWAN PRIYATNA | MENEMBAK | NTB | 2120005560 |
| 5 | ROBY CAHYADI | MENEMBAK | NTB | 2120005561 |
| 6 | LALU EGA NENDITIA | KARATE | NTB | 2120005562 |
| 7 | DR. DADANG WARTA CANDRA WK | BASKET | NTB | 2120005563 |
| 8 | DR. SOEMARDIAWAN | BALI UNITED | NTB | 2120005564 |
| 9 | ANDI ANSHARI BAUSAD | SEPAKBOLA | NTB | 2120005565 |
| 10 | NOOR KHAIRUDIN | BASKET | NTB | 2120005566 |
| 11 | NURUL ISNAENI | BULUTANGKIS | NTB | 2120005567 |
| 12 | MUZAINI | KEMPO | NTB | 2120005568 |
| 13 | AUNOL YAKIN | BILYARD | NTB | 2120005569 |
| 14 | MULYANTO | RENANG | NTB | 2120005570 |
| 15 | NURHAWAN | ATLETIK | NTB | 2120005571 |
| 16 | BASUKI SRIHERMANTO | BALAPSEPEDA | NTB | 2120005572 |
| 17 | RASTO BIMANTORO | TENIS LAP. | NTB | 2120005573 |
| 18 | BUDI SANTOSO SUHARTO | TENIS LAP. | NTB | 2120005574 |
| 19 | SOPAN SOPIAN | TAEKWONDO | NTB | 2120005575 |
| 20 | YACOB PANIE | BALAP MOTOR | NTB | 2120005576 |
| 21 | FIRMAN SATRIAWAN | PENCAKSILAT | NTB | 2120005577 |
| 22 | I KETUT WARA | SENAM | NTB | 2120005578 |
| 23 | NI MADE WIDIARTI | SENAM | NTB | 2120005579 |
| 24 | R. DINI HARI SURYANTO | BRIDGE | NTB | 2120005580 |
| 25 | PAHRURROZI ZAEN | PNJAT TEBING | NTB | 2120005581 |
| 26 | LUKMAN, SPD | SPK TAKRAW | NTB | 2120005582 |
| 27 | RINA DWI ASTUTI | PENCAKSILAT | NTB | 2120005583 |
| 28 | IMAN AFANDI, S.PD | TENIS MEJA | NTB | 2120005584 |
| 29 | ACHMAD FAUZAN AZIM | FUTSAL | NTB | 2120005585 |
| 30 | DRS. EFDAL MS, MM | TENIS LAP. | NTB | 2120005586 |
| 31 | LALA LATIFA ANNISA | TENIS LAP. | NTB | 2120005587 |
| 32 | ISMAIL ANAWOMA | SEPAKBOLA | NTB | 2120005588 |
| 33 | WAHYU HIDAYAT | FUTSAL | NTB | 2120005589 |
| 34 | ALFIAN SEPTIANTO | PENCAKSILAT | NTB | 2120005590 |
| 35 | AJUS KARNAEN | PENCAKSILAT | NTB | 2120005591 |
| 36 | SYAHDAN | KARATE | NTB | 2120005592 |
| 37 | ARI PURNOMO | PNJAT TEBING | JATENG | 2120005593 |
| 38 | LILIS KARLINA | NTB | 2120005594 | |
| 39 | M. WIRAWAN HIDAYAT | NTB | 2120005595 | |
| 40 | MUHAMMAD ARDIANSYAH | NTB | 2120005596 | |
| 41 | FATMAWATI | NTB | 2120005597 | |
| 42 | MAWARDI | NTB | 2120005598 | |
| 43 | RENA RIZKIA SAPTIANI | NTB | 2120005599 | |
| 44 | CITRA PUTRI BUDI ANDINI | MENEMBAK | NTB | 2120005600 |
| 45 | ANDIK BUDI HARTONO | MENEMBAK | NTB | 2120005601 |
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