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Coach's General Information

ATHELITIC MEET PRVONCIAL ATHLETIC MEET


VENUE IROSIN, SORSOGON
DATE NOVEMBER 7 - 9, 2017
COACH 1 INFORMATION
COACH : JOEY L. GARCIA
SCHOOL : CUMADCAD NHS
POSITION TEACHER III
AGE 32
GENDER MALE
DATE OF BIRTH JULY 30 1985
DATE OF ORIGINAL APPOINTMENT JANUARY 8, 2008
EVENT VOLLEYBALL (GIRLS)

1/10/1994 8/1/2017

282
al Information

FORMATION
Republic of the Philippines
Department of Education
Region V
DIVISION OF MASBATE

CERTIFICATE OF EMPLOYMENT
(for DepEd Personnel)

Date

To Whom It May Concern:

This is to certify that Mr./Ms. JOEY L. GARCIA is

presently employed in CUMADCAD NHS as TEACHER III , since

JANUARY 8, 2008 or for a period of 282 months.

This certification is issued upon the request of Mr./Mrs. JOEY L. GARCIA

to coach in PRVONCIAL ATHLETIC MEET

at IROSIN, SORSOGON .

School Head/ Administrative Officer

FOR PALARONG PAMBANSA ONLY


(for DepEd Personnel)

(for Private School)

School Administrator/Official
School Head/ Administrative Officer
Republic of the Philippines
Department of Education
Region V
DIVISION OF SORSOGON
Capitol Compuond, Sorsogon City

CERTIFICATION

This is to certifiy that JOEY L. GARCIA completed the


fourty eight (48) hours sports training during the Division Accreditation for Coaches
on August 18-20, 2017 at Balogo Sports Complex, Sorsogon City and Regional Seminar
Training on Coaching in Various Sports Disciplines on December 5-7, 2016 at Ibalong
Centrum for Recreation, Legazpi City.

Issued this 29th day of November 2017 at Sorsogon City, Philippines.

ANACLETO B. OTIVAR
EPS-I/ Division School Sports Officer

FOR PALARONG PAMBANSA ONLY


Republic of the Philippines
Department of Education
Region V
DIVISION OF MASBATE
Rodeo Road, Masbate City

CERTIFICATION

This is to certifiy that JOEY L. GARCIA served


for at least one (1) year as coach/chaperone/trainer in VOLLEYBALL (GIRLS)

Issued this 19th day of January 2017 at Masbate City, Philippines.

ANACLETO B. OTIVAR
EPS-I/ Division School Sports Officer

FOR PALARONG PAMBANSA ONLY


Republic of the Philippines
Department of Education
Region V
DIVISION OF MASBATE
Rodeo Road, Masbate City

CERTIFICATION

This is to certifiy that JOEY L. GARCIA participated as


coach in the lower meets.

Issued this 19th day of January 2017 at Masbate City, Philippines.

ANACLETO B. OTIVAR
EPS-I/ Division School Sports Officer

FOR PALARONG PAMBANSA ONLY


Republic of the Philippines
Department of Education
Region V
DIVISION OF MASBATE
Rodeo Road, Masbate City

CERTIFICATE OF MEMBERSHIP

This is to certifiy that JOEY L. GARCIA is an active


member of DEPED MASBATE SPED ASSOCIATION This
certificate also serves as recognition of his/her commitement to the development of
VOLLEYBALL (GIRLS) in the Division of Masbate Province.

Issued this 19th day of January 2017 at Masbate City, Philippines.

ANACLETO B. OTIVAR
EPS-I/ Division School Sports Officer
Adviser

FOR PALARONG PAMBANSA ONLY


Republic of the Philippines
Department of Education
Region V
DIVISION OF MASBATE
Rodeo Road, Masbate City

CERTIFICATE OF ACCREDITATION

This is to certifiy that JOEY L. GARCIA is duly


accredited coach in VOLLEYBALL (GIRLS) and passed the Division Accreditation
for coaches on November 4-6, 2016 at Mobo North Central School, Mobo, Masbate.

Issued this 19th day of January 2017 at Masbate City, Philippines.

ANACLETO B. OTIVAR
EPS-I/ Division School Sports Officer

FOR PALARONG PAMBANSA ONLY


Republic of the Philippines
Department of Education
Region V
DIVISION OF MASBATE

M E D I CAL C E R T I FI CAT E

(Date)

To Whom It May Concern:

This is to certify that I have personally examined JOEY L. GARCIA


Name
age 32 sex MALE born on JULY 30 1985 and have found that he/she is

physically fit, during the time of examination, to join and compete in the Lower Meets and

Palarong Pambansa.

Event: VOLLEYBALL (GIRLS)

Physical Examination

Date examined:

Height: Weight: Blood Pressure:


Pulse, Resting: Respiratory Rate:
Other Remarks:

Physician/Medical Officer
(Signature over printed name)
License No. :
PTR.:
Date:

FOR PALARONG PAMBANSA ONLY


Republic of the Philippines
City of ______________________)S.S.

SWORN STATEMENT

I JOEY L. GARCIA , of legal age, single/married, with postal address at


, after having duly sworn in accordance with law hereby depose and state:

That I am presently employed with the CUMADCAD NHS as


TEACHER III ;

That I have been employed in DEPED DIVISION OF MASBATE


since JANUARY 8, 2008 or for a period of 282months. ;

That I was designated as coach of VOLLEYBALL (GIRLS) , who will participate in the
PRVONCIAL ATHLETIC MEET

That all the athletes are not members of the National Team, National Training Pool and Development
Pool receiving monthly stipend/allowance from the Philippine Sports Commission (PSC);

That all the athletes records submitted are true and correct to the best of my personal knowledge;

That all the athletes of VOLLEYBALL (GIRLS) , who will participate in the
PRVONCIAL ATHLETIC are eligble;

That I execute this Affidavit to attest to the authenticity and veracity of all the documents submitted.

IN WITNESS WHEREOF, I have hereunto set my hand this day of


2017 in Masbate City, Philippines.

Affiant

SUBSCRIBED AND SWORN TO before me this day of JANUARY , 2017


in Masbate City, Philippines, affiant exhibiting to me his/her Government issued ID/SSS/PRC/Philhealth, etc.
.

MARIA G. DAGÑALAN
Administrative Officer V

FOR PALARONG PAMBANSA ONLY


Republic of the Philippines
City of ______________________)S.S.

AFFIDAVIT

I JOEY L. GARCIA , of legal age, single/married, with postal address at


, after having duly sworn in accordance with law hereby depose and state:

That I am presently employed with the CUMADCAD NHS as


TEACHER III ;

That I have been employed in CUMADCAD NHS


since JANUARY 8, 2008 or for a period of 282months. ;

That I was designated as coach of VOLLEYBALL (GIRLS) , who will participate in the
2017 Palarong Bikol;

That all the athletes are not members of the National Team, National Training Pool and Development
Pool receiving monthly stipend/allowance from the Philippine Sports Commission (PSC);

That all the athletes records submitted are true and correct to the best of my personal knowledge;

That all the athletes of VOLLEYBALL (GIRLS) , who will participate in the 2017 Palarong
Bikol are eligible;

That I execute this Affidavit to attest to the authenticity and veracity of all the documents submitted.

IN WITNESS WHEREOF, I have hereunto set my hand this day of JANUARY


2017 in Masbate City, Philippines.

Affiant

SUBSCRIBED AND SWORN TO before me this day of JANUARY , 2017


in Masbate City, Philippines, affiant executing his/her Community Tax Certificate No.
issued at . on .

Notary Public

FOR PALARONG PAMBANSA ONLY

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