Republic of the Philippines

Department of the Interior and Local Government

144 Mindanao Avenue, Project 8, Quezon City

BJMP SAT FORM

_______________________________________________________________
Rank/Name (Family Name, First Name, Middle Name, Qualifier

GENERAL INFORMATION

Age: Gender: Civil Status:

Office Assignment: Position/Designation:

STRENGTH AND AGILITY TEST

EVENTS RAW SCORE POINTS SCORER’S NAME &

SIGNATURE
PULL-UP
PUSH-UP
SIT-UP
100M SPRINT
1000M RUN

REMARKS:
AVERAGE
PASSED FAILED

Evaluated by:

_______________________________
(Name & Signature of Evaluator)

I hereby certify that I have been duly informed of the mechanics of the above examinations.

_______________________________
Name & Signature of Examinee

_______________________________
Date