DO NOT WRITE ON THIS SPACE

[For PDO I – YFP/SPG/SSG use only]

*This form may be photocopied/reproduced

Date Received: __________________

Republic of the Philippines School Club/Organization ID No:

Department of Education
-
SCHOOLS DIVISION OF SANTIAGO CITY
STUDENT ORGANIZATION AND CLUB APPLICATION FORM
School Year 20___-20___
*Please accomplish this form in bold letters and using black or blue pen only.
 New Application  Renewal Application
Name of
Organization:
 Subject-Related  Athletic/Game  Special Interest
Category:
 Culture & Arts  Others _________________________________
Full Name of Adviser:
Email Address: Contact Number[s]:
Full Name of Co-Adviser:
Email Address: Contact Number[s]:
Full Name of President:
Email Address: Contact Number[s]:
Attached are the following supporting documents required for Supreme Pupil/Student Government,
School Head and Division’s Recognition:
 Organization/Club’s Constitution and By-Laws  Accomplishment Report of previous School Year
 Action Plan  List of Elected Officers and Members
We hereby assemble this Organization/Club and agree to fulfill the mission and purpose for which it was established
to the best of our abilities.

_________________________________ _________________________________
Signature over printed name of Club President Signature over printed name of Club Adviser
Date: ____________________________ Date: ____________________________
-------------------------------------------------------------------------------------------------------------------------------
SCHOOL LEVEL [Assessment and Endorsement]:
 All documentary requirements complied.
 Returned to applicant due to:
 Incomplete documentary requirements.
 Need revision[s] (Please see corrections/feedbacks on the supporting documents).
 Endorsed for approval.
_________________________________ _________________________________
Signature over printed name of SPG/SSG President Signature over printed name of SPG/SSG Adviser
Date: ____________________________ Date: ____________________________
Recommending Approval:
_________________________________
Signature over printed name of School Head
-------------------------------------------------------------------------------------------------------------------------------
Approved:
CHERRY S. RAMOS, EdD, CESO V
Schools Division Superintendent

Address: Children’s Park, Calaocan, Santiago City, 3311

Telephone Nos.: (078) 682-0151; (078) 682-0156
Email Address: santiago.city@deped.gov.ph
Website: deped-santiagocity.com.ph