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. fsa Sea Fame of Scheel ‘adarene ‘al ares aa _ as ‘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