NESTLÉ WELLNESS CAMPUS OF THE YEAR

REGISTRATION FORM

Region: _National Capital Region_________

Division: _Caloocan_____________________

SCHOOL INFORMATION:
Name of School: CALOOCAN NORTH ELEMENTARY SCHOOL
____________________________________________________________
Category: 
x Grade School  Junior High School
School Address: PH. 6, PKG. 1, CAMARIN, CALOOCAN CITY
____________________________________________________________

Contact Person: MR. MARLON C. MARTINEZ

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Contact number/s: 09100299203
____________________________________________________________
Email address: ____________________________________________________________
marlon.martinez21@deped.gov.ph
Principal: ____________________________________________________________
CARMENIA C. ABEL, Ed. D.

By submitting this registration form we hereby:

1. Confirm our participation in the SY 2020-2021 Nestlé Wellness Campus of the Year Competition
2. Understand the full mechanics and abide by the rules and regulation of the contest
3. Agree to represent our Division and Region in the Nestlé Wellness Campus of the Year
Competition
4. Certify that we have started the implementation of the Nestlé Wellness Campus program as pre-
requisites to the contest

Kindly place the date when you have started with the program implementation of the following activities:
 Wellness Campus Dancercise
FEBRUARY 15, 2021
Start Date: __________________

 School Healthivities
Start Date: __________________
FEBRUARY 15, 2021

 Wellness Campus Modules Integration

Start Date: __________________
MARCH 1, 2021
MARLON C. MARTINEZ
________________________
School Representative’s Signature over Printed Name
TEACHER 1
_______________________
Designation
MARCH 15, 2021
________________________
Date