| No. | Nama | PROVINSI | CABOR | NO. PLTH |
| 1 | DAFFA HAFIZH RIZQIKA RIZAL | JAKARTA | SEPAKBOLA | 192003811 |
| 2 | FAZAN NUR WAHID | JA TENG | SEPAKBOLA | 192003812 |
| 3 | MUHAMMAD TAUFIQ HIDAYAT | JAWTENG | FUTSAL | 192003813 |
| 4 | MOH. RIDWAN | JABAR | SEPAKBOLA | 192003814 |
| 5 | ROFA ICHSANDI | JATENG | TAEKWONDO | 192003815 |
| 6 | ACHTEN NUNGKI ALFA SANATULLOH | JATENG | KARATE | 192003816 |
| 7 | DONI KURNIAWAN | JATIM | FUTSAL | 192003817 |
| 8 | YANDRA RAHADIAN PERDANA | YOGYA | FUTSAL | 192003818 |
| 9 | M. ALFIAN TANJUNG | JATENG | SEPAKBOLA | 192003819 |
| 10 | AKBAR SATRIA PANUNTUN | JATENG | BASKET | 192003820 |
| 11 | IGNATIUS BIMA KRISDINANTYO | JABAR | FUTSAL | 192003821 |
| 12 | WAHYUNINGSIH | JATENG | RENANG | 192003822 |
| 13 | AHMAD BADAWI | JATENG | SEPAKBOLA | 192003823 |
| 14 | ANGGA KUSUMAWARDHANNY | JATENG | BULUTANGKIS | 192003824 |
| 15 | MOH. ARIF RAHMAN HAKIM | JAWTENG | FUTSAL | 192003825 |
| 16 | SUNARMIN | JAWA TENGAH | SEPAKBOLA | 192003826 |
| 17 | NUR SYARIF HIDAYAT | JAWA TENGAH | PENCAK SILAT | 192003827 |
| 18 | KAMAL KURNIAWAN | JAWA TENGAH | FUTSAL | 192003828 |
| 19 | SRI PURWANTO | JAWA TENGAH | SEPAKBOLA | 192003829 |
| 20 | HERI KOESTRIYONO | JAWA TENGAH | TENIS | 192003830 |
| 21 | SUROSO | JAWA TENGAH | SEPAKBOLA | 192003831 |
| 22 | YOHANES FRANSISCUS LAMINTANG | JAWA TENGAH | SEPAKBOLA | 192003832 |
| 23 | DIMAS KURNIAWAN | JAWA TENGAH | SEMUA CABOR | 192003833 |
| 24 | M. IRFAN | JAWA TIMUR | FUTSAL | 192003834 |
| 25 | FAJAR Kurniawan | JAWA BARAT | RENANG | 192003835 |
| 26 | EDDY SANYOTO | JATENG | B VOLI | 192003836 |
