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Republic of the Philippines

Department of the Interior and Local Government


BUREAU OF FIRE PROTECTION
NATIONAL CAPITAL REGION – REGIONAL OFFICE
Ermin Garcia St., Brgy. Pinagkaisahan, Cubao, Quezon City
Tel. Number: (02) 8982-4433
Email: admbfpncr@yahoo.com

BFP PHYSICAL AGILITY TEST FORM

NAME: _____________________________________________________ DATE: _________________

AGE: ________________ SEX: ________________

MEDICAL REMARKS:

BP: ____________ GO:


HEIGHT: ____________
NO GO:
WEIGHT: ____________

CONDUCTED BY: ___________________________________


Member, Medical Team

EVENTS NO. OF REPETITION POINTS

1. PULL-UPS (MALE)

2. HANG LIKE A BAT (FEMALE)

3. PUSH-UPS

4. SIT-UPS

5. FLATTER KICK

COMPLETION TIME

6. 100-METER RUN

7. 3K ENDURANCE RUN

TOTAL POINTS:

________________________________
Signature of Applicant

REMARKS:

PASSED FAILED

PASSING SCORES:
MALE: 75%
FEMALE: 75%

Conducted by: Certified Correct by:

_____________________________ SINSP GLEN C CELESTIAL


Member, PAT Committee Vice-Chairperson, PAT Committee
Republic of the Philippines
Department of the Interior and Local Government
BUREAU OF FIRE PROTECTION
NATIONAL CAPITAL REGION – REGIONAL OFFICE
Ermin Garcia St., Brgy. Pinagkaisahan, Cubao, Quezon City
Tel. Number: (02) 8982-4433
Email: admbfpncr@yahoo.com

Noted by:

SUPT BERNARD P BATNAG JR


Chairperson, PAT Committee

Control No: __________

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