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Republica the Bhtiovines
Beparimtent of Coucation
BUREAU OF LEARNER SUPPORT SERVICES
FORM S5C.1: SCHOOL SPORTS CLUB REGISTRATION FORM
INSTRUCTIONS: Input the necessary details, Indiate N/A if not applicable, DO NOT ABBREVIATE.
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Fame of Scheel
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‘Website URL fifany)
i SEE OE a aT a |
3F Mabini Building. DepEd Complex, Meralo Averue, Pasig ORy
Telephone No. (02) 632-9935; (02) 638.8525 [Esper eras
1 Mandatory Sports
Alea three out of etx mandatory sports: however you may establish any prefered sports cu,
Ca Preferred Sports ears
Declaration:
Thereby declare the information provided in this application is true and correct and there have been no
‘misleading statements, omission of any relevant facts nor any misinterpretation made,
Prepared by: Jin
[ Sports Cinb Coordinator os
Sigaatare | a
Date
Verified by:
Division Sports Officer
Signature:
Date
‘ie Tarn not wad rege
Required Attached Document: Accomplished Form $5C.2 Schoo! Sports CiubAttachinent Porm
'3F Mabini Bullding, DepEd Complex, Meralco Avenue, Pasig Gty e
Telephone No. (02) 632-9835; (02) 638.8525 Department of Education
BUREAU OF LEARNER SUPPORT SERVICES
FORM SSC.2: School Sports Club Attachment Form
INSTRUCTIONS: Input the necessary detuils. Indicate N/A if not applicable.
DO NOT ABBREVIATE,
1. SPORTS CLUB INFORMATION
or mare sports cube are Aad rows
‘Sports Club Facilitator/si
‘Sports Club Member/s:
Members’ Name
Established Date:
‘Sport's Glub Name
Established Date:
‘Sports Club Facilitator[a:
[ Sports Giub Member/s:
_ Members’ Name Grade Level
[3 Mabini Builing, DepEd Complex, Meaica Avenue, PasigGty
Telephone No. (02) 632-9535; (02) 638-8525 TL. PROGRAMMING
ut the prfered tin. Add rows end columns
‘Time ‘Sports Club ‘Mon [Tues | Wed [Thurs | Fa] Sat
‘Example,
‘Amis Sports Cab Sect agai
‘Chess Sports Club cad
'S:00PM-6:00PM_| Sepaktaleraw Sports Club
a the wefered tine schedule, Add rows and eotumns i recess
(“time Varsity Club
‘Wed_[Thurs [Fa [Sat
AML, LIST OF AVAILABLE SPORTS EQUIPMENT AND SPORTS FACILITIES
"ok the box standard sports equipment and faites are avallabla and reedy use. Put remarks and add rus if nocessary
|
“Learning Pucileics
[rack and Geld oval
‘Gymnasium / covered court
Basketball court
Volleyball court i
‘Swimming. pool H
Football/ softball baseball fel —_——|
Spacious paving area
ofo[ofojojojaja
‘Sports Equipment Remarks
O[o/o[ofofojalo[ojo[oj ofo
3F Mabin| Building, DepEd Complex, Meraloo Avenue, Pasig Cy
Telephone No. (02) 632-9935; (02) 638-8525 . IV SPORTS ACTIVITIES, PR AMS AND/OR PROJECTS
‘Gea teast (9) Oe recent Ossie, programs, projects or any eer iiativesinplamented related to sports
‘ad ruse necessary.
___etivities [Programs] Projects Date of implementation
Declaration:
hereby declare the information provided in this application is true and correct and there have been no
‘misleading statements, omission of any relevant facts nor any misinterpretation made.
Prepared by: i
‘Sports Club Coordinator
i ‘Signature: E 7
H ‘Date
Certified by:
Principal/Officerin-Charge
‘Signature
Date
Verified by:
'3F Mabini Building, DepEd Complex, Maraico Avenue, Pasig City
‘Telephone No. (02) 632-9935; (02) 638-8525
