Form A University of Antique

Sibalom, Antique

_______________________________________________________________________________

PHYSICAL FITNESS TEST (PFT) SCORE CARD

S.Y. 2023 - 2024

NAME: _________________________________ GRADE/SECTION: __________________AGE: _____ SEX: ____

SCHOOL: ___________________________ DISTRICT: ______________ DATE OF BIRTH: __________________

PART I. HEALTH – RELATED FITNESS TEST

PRE-TEST POST-TEST
PARAMETERS ACTIVITIES
(1st Quarter) (4th Quarter)
Body Mass Index (BMI)  Height (meters)
A. BODY  Weight (kilograms)
COMPOSITION BMI = Weight (kg.)  BMI
Height (m)2  Classification
Heart Rate Per Minute
B. CARDIOVASCULAR 3 – Minute Step Test  Before the Activity
ENDURANCE Heart Rate Per Minute
 After the Activity
 SCORE
C. STRENGTH 90 Degrees Push-Up  Number of Push-Up
Basic Plank  Time (00:00)
Zipper Test Overlap Gap – Right Arm (cm)
D. FLEXIBILITY Overlap Gap – Left Arm (cm)
 First
Sit and Reach (cm)  Second

PART II. SKILL – RELATED FITNESS TEST

PARAMETERS ACTIVITIES PRE-TEST POST-TEST

A. COORDINATION Juggling  Score: Number of Hits
 Clockwise Time (00:00)
B. AGILITY Hexagon Agility Test  Counter Clockwise Time
C. SPEED 40 Meter Sprint  Time (00:00)
 First Trial (cm)
D. POWER Standing Long Jump  Second Trial (cm)
(distance in cm)
Stork Balance Stand Test  Right Foot Time (00:00)
E. BALANCE  Left Foot Time (00:00)
 First Trial (cm)
F. REACTION TIME Stick Drop Test  Second Trial (cm)

LUELYN B BAUTISTA MAT-HK YEHLEEN D PANAGUITON, MAEd, MAT-HK

INSTRUCTOR 1 Name of Area Head
 Department of Education
Region VI
DIVISION OF ANTIQUE
Pis-anan National High School

PHYSICAL FITNESS TEST (PFT) SCORE CARD

S.Y. 2022-2023

Name: _____________________________Grade&Sec.______________

SKILL – RELATED FITNESS TEST

Coordination: Juggling ________________

Agility: Hexagon Agility Test _____________________

Speed: (40 meter sprint) _____________________

Power: (Standing Long Jump)________________________

Balance; R: _____________________________ L:____________________

Reaction Time: 1st: __________________ 2nd: ________________

Subject Teacher