Republic of the Philippines

Department of Education
MIMAROPA REGION
SCHOOLS DIVISION OF MARINDUQUE

FORM SSC 1. SCHOOL SPORTS CLUB REGISTRATION FORM

INSTRUCTIONS: Input the necessary details. Indicate N/A if not applicable. DO NOT ABBREVIATE.

a. Basic Information
Region: MIMAROPA REGION Division: SCHOOLS DIVISION OF MARINDUQUE
Name of School: DAWIS ELEMENTARY SCHOOL School ID: 109928
Address: DAWIS, GASAN, MARINDUQUE
Email Address (if any) 109928dawis@gmail.com Telephone No:
Website URL (if any)
B. School Profile

Dawis Elementary School is located along the highway in Dawis, Gasan, Marinduque.
It’s relative distance from Poblacion and the Schools District Office is 8 km and 26 km
away from the Schools Division Office while 2.17 km from the nearest public elementary
school (Pinggan ES), 4 km from the nearest public secondary school (Bognuyan National
High School), 0.22 km from the nearest private secondary school (Marinduque Christian
Academy-MCA). It is accessible by tricycle, jeepney or any other mode of transportation.

The school is very quit as well as pollution free. It is well furnished including essential
Science equipment, library, as well as computer room. There is a conference hall in which
the entire General Parent Teachers Association (GPTA) meeting and conferences take
place. The school provides learners with a safe learning environment in which to nature
and grow emotionally, behaviorally and academically and at the same developing
relationship with others. Each and every learner requires situation, respect, stability,
limitation and boundaries and safe environment in the school. there are the things that
positively influence learners performance. such thing shaving good friends within the
school perceiving that teachers are caring and supportive, believing that discipline is
efficient and fair. Participating in extra curricular activities, being a part of a school and
having sense of belonging. Learners become incorporated in their environment when they
perceive that teachers in the school mind about them as individual and their learning.

It is evident that school and community work closely with each other to meet nurture
goals. Both community and school have linkage as the school cannot be seen as
independent institution that is isolated from the society in which it is located. Linkage
between these two institution are proven effective way for the school to expand and
provide more meaningful learning experiences, making a real differences in the lives of
children, families and community. School and community linkages engage parents to
improve children’s educational outcomes. Parents involvement practices such as
monitoring children’s homework, reading to them and volunteering in school are linked to
learners positive academic and achieve goals. Stakeholders continuously supports the
activities of the school by giving donation, in the form of money, in kind, time and effort.

DAWIS ELEMENTARY SCHOOL

109928dawis@gmail.com
School ID: 109928
 The activities to which the stakeholders show full support are as follows: Adopt A School
Program, Clean Up Drive and other school projects that help in developing the skills and
knowledge of the learners. Effective school community partnership are built on open
dialogue and communication.

C. Sports Club
C.1. Mandatory Sports
At least three out of six mandatory sports; however, you may establish any preferred sports
club. Add rows if necessary
1.Chess
2.Athletics
3.Basketball
4
5.
6.
C. 2. Preferred Sports
Add rows if necessary.
1. Badminton
2.Chess
3.Athletics
4.Baseball
5.Basketball
6.
7.

Declaration:

I 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:
Sports Club Coordinator JUNE M. SADIWA
Signature

Date January 9, 2023

Certified by:
Principal/Officer-in-charge MYLENE M. FORTEZA
Signature
Date January 9, 2023

Verified by:
Division Sports Officer MAITA M. LAZARES
Signature
Date January 9, 2023

This form is not valid if not signed.

Required Attached Document: Accomplished Form SSC 2. School Sports Club Attachment Form.

DAWIS ELEMENTARY SCHOOL

109928dawis@gmail.com
School ID: 109928
FORM SSC. 2: School Sports Club Attachment Form
INSTRUCTION: Input the necessary details. Indicate N/A if not applicable.
DO NOT ABBREVIATE

I. SPORTS CLUB INFORMATION

Create a copy of this page if four or more sports clubs are being offered. Add rows and columns if necessary.
Sports Club Name: Basketball Sports Club
Established Date: January 9, 2023
Sports Club Facilitator/s: Shella Marie A. Priolo / Arlin M. Pomida
Sports Club Member/s:
Members Name Grade Level
1. Kareem Rakeem A. Montuya 5
2. Mark Jefferson S. Montuya 5
3. Remuelle Diokno 5
4. Prince Brennan Semilla 5
5. Levron James M. Ricamara 5
6. Rye Nigel S. Ricamra 5
7. Ace Yohan S. Cepida 5
8. Vhon Chandler M. Pascual 5
9. Unique A. Fabaleña 5
10. Brix Archie S. Sapungan 5
11. Jimuel Rolloque 5
12. Justine Ezekiel Vitto 5
13. Van Reign S. Sace 5
14. Jhon Rein Lumagui 5
15. Mark Jude H. Rey 4
16. Evert Saez 4
17. Windel V. Guevara 4
18. Nathan Sapungan 4
19. Jeu Nel Albano 4
20. Jhon Markiel Rolloque 4
21. Yuan Leobert Zoleta 4
22. Jimuel M. Rolloque Jr. 5
23. Isiah Manuel Labriaga 5

Sports Club Name: Badminton Sports Club

Established Date: January 9, 2023
Sports Club Facilitator/s: Rowena H. Rey / Anielor S. Matining
Sports Club Member/s:
Members Name Grade Level
BOYS
1. Jhon Mithrill M. Minay 5
2. Lebron James S. Sosa 4
3. Clark Nathaniel . Gordora 5
4. Zian Lee B. Gordora 4
GIRLS
1. Jesse Andrea Lope 5
2. Sabrina Omega Z. Seda 5
3. Redge Ashley Arroyo 5

DAWIS ELEMENTARY SCHOOL

109928dawis@gmail.com
School ID: 109928
4. Solen S. Sarmiento 6
5. Jan Nicole Zoleta 6
6. Kyle R. Macarayan 4
7. Shaira Mae S. Cagayon 5
8. Shara Mae Z. Tan 4

Sports Club Name: Athletics Sports Club

Established Date: January 9, 2023
Sports Club Facilitator/s June M. Sadiwa / Sotie S. Cucio / Hylen S. Sarmiento
Sports Club Member/s:
Members Name Grade Level
BOYS
1. Alexus Conrad S. Encarnacion 5
2. Elmar S. Dela Cruz 5
3. Adrian M. Estrada 5
4. Eric M. Seń o 6
5. Jean Cloud G. Sosa 4
6. Neil Greizon S. Nopre 5
7. Denver Labuanan 5
8. Jay Lord M. Rolloque 4
9. King Justine R. Yongson 4
10. Nijea R. Diamante 4
11.Jerson M. Malaylay 4
12. Mikko P. Vallano 4
13. Zhianly Saez 4
GIRLS
1. Cristine Joy R. Porlaje 5
2. Vina R. San Andres 5
3. Jemia Y. Rosales 5
4. Anjemay S. Gamboa 5
5. Carmela Reyes 5
6. Ruffa Mae M. Marasigan 4

Sports Club Name: Baseball Sports Club

Established Date:January 9, 2023
Sports Club Facilitator/s: Elmar S. Sadiwa / Rona S. Sadiwa
Sports Club Member/s:
Members Name Grade Level
1. Zagie M. Minay 6
2. Ivan Josh S. Pereda 4
3. Nieghel H. Sales 4
4. Jan Erick L. Semilla 6
5. Miguel S. Maming 6
6. Prince Joven P. Dahab 6
7. Jhon Paul S. Dizon 6
8. Jhon Carl R Tan 6
9. Mark Jefferson S. Montuya 3
10. Prince Kareem A. Montuya 3

DAWIS ELEMENTARY SCHOOL

109928dawis@gmail.com
School ID: 109928
11. Isaiah T. Labriaga 4
12. Elmar S. Dela Cruz 5
13. Alexus Conrad S. Encarnacion 5
14. John Dimver O. Sapungan 6
15. Rohan M. Hernandez 6
16. Jhon Carl M. Rolloque 6
17. Earl Jhayzen T. Sapungan 6
18. Axel James Q. Marasigan 6
19. Vhon Chandler M. Pascual 5

Sports Club Name: Chess Sports Club

Established Date: January 9, 2023
Sports Club Facilitator/s: Irly J. Sosa / Mary Josephine V. Jamolin
Sports Club Member/s:
Members Name Grade Level
1. Jairo Sabida 5
2. Rhenzfel G. Sapungan 5
3. Giselle V. Guevara 5
4. Pia M. Hechanova 5
5. Reanna May M. Ferrer (observer) 5
6. Cris Rodin S. Cabayan (observer) 5

Sports Club Name: Volleyball Girls Sport Club

Established Date:January , 2023
Sports Club Facilitator/s: Aideliza S. Alita
Sports Club Member/s:
Members Name Grade Level
1. Zyrah Evein G. Sace 6
2. Jowelyn Zoleta 6
3. Krishna Claire S. Motol 6
4. Rhian Jane R. Sapungan 6
5. Mariel Z. Longoy 5
6. Stephanie Anne S. Rojas 5
7. Novielyn M. Seń o 5
8. Larisha M. Seda 5
9. Angelica M. Rolloque 5
10. Alliyah Marie S. Rolloque 5
11. Leejen M. Rolloque 5

Sports Club Name: Field Demo

Established Date:January , 2023
Sports Club Facilitator/s: Aideliza S. Alita
Sports Club Member/s:
Members Name Grade Level
1. Solen S. Sarmiento 6
2. Jan Nicole O. Zoleta 6
3. Sheena Mae S. Acuń a 6
4. Zagie M. Minay 6
5. Eureka Ashielle H. Maranan 6

DAWIS ELEMENTARY SCHOOL

109928dawis@gmail.com
School ID: 109928
6. Aira Demeterio 6
7. Ann Lorraine Rolloque 6
8. Redge Ashley S. Arroyo 5
9. Shaira Mae S. Cagayon 5
10. Princess Lhara Ibarrientos 5
11. Jesie Andrea O. Lope 5
12. Ma. Bea De Villa 3
13. Rheana May Ferrer 5
14. Shara Mae Tan 4
15. Ma. Lheans Mhel Reanzares 4
16. Faim Nathalie Sapungan 4
17. Ashly Jane Sotta 4
18. Katriona Ava Mischel Orencio 4
19. Cassandra Sace 4
20. Jessielyn Rublica 4
21. Mary Alexis Rolloque 4
22. Chloey Seth A. Priolo 4
23. Catherine Mandia 3
24. Aliana Valencia 3
25. Reign Saez 3
26. John Jake Saez 3
27. Alexis Marasigan 3
28. Meagan Sadiwa 3
29. Mayrene Garay 3
30. Janine Sager 3
31. Jan Trixie Zoleta 3
32. Vienna Irish Seno 3
33. Shakea Sager 3
34. Ray Allen Obuyes 3
35. Precious Devine Sosa 3
36. Jacob Angelo Vitto 3
37. Karylle Jane Esteron 3
38. Ian Jay San Juan 3
39. Angel Sapungan 4
40. Colline Minay 4

Sports Club Name: Dance Sports Club

Established Date: January , 2023
Sports Club Facilitator/s: Arlin M. Pomida
Sports Club Member/s:
Member’s Name Grade Level
1. Jonas R. Monteverde 6
2. Aleah Jane R. De Villa 3
3. Mark Jerome P. Pascual 5
4. Redge Ashley C. Arroya 5

DAWIS ELEMENTARY SCHOOL

109928dawis@gmail.com
School ID: 109928
II. PROGRAMMING
Put the preferred time schedule. Add rows and columns if necessary
Time Sports Club Mon. Tues. Wed Thurs. Fri. Sat.
.
Example
4:00 – 5:00 PM Basketball Sports Club /
4:00 – 5:00 PM Badminton Sports Club /
4:00 – 5:00 PM Baseball Sports Cub /
4:00 – 5:00 PM Chess Sports Club /
4:00 – 5:00 PM Volleyball Sports Club /
4:00 – 5:00 PM Athletics Sports Club /

Put the preferred time schedule. Add rows and columns if necessary
Time Varsity Club Mon. Tues. Wed Thurs. Fri. Sat.
.
4:00-5:00 Basketball Sports Club /
4:00-5:00 Badminton Sports Club /
4:00-5:00 Baseball Sports Cub /
4:00-5:00 Chess Sports Club /
4:00-5:00 Volleyball Sports Club /
4:00-5:00 Athletics Sports Club /

III. LIST OF AVAILABLE SPORTS EQUIPMENT AND SPORTS FACILITIES

Tick the box if standard sports equipment and facilities are available and ready to use. Put remarks and
add rows if necessary.

Learning Facilities Remarks

Basketball Court Barangay Hall
Volleyball Court Dawis Elementary School
Spacious Playing Area Dawis Elementary School

Others:
________________________________
________________________________
________________________________
________________________________

Sports Equipment Remarks

Basketball ball Serviceable
Volleyball ball Serviceable
Chess board Serviceable
Badminton racket Serviceable
Baseball bat and ball Serviceable

DAWIS ELEMENTARY SCHOOL

109928dawis@gmail.com
School ID: 109928
 IV. SPORTS ACTIVITIES, PROGRAMS, AND/OR PROJECTS
Give at least (3) three recent activities, programs, projects, or any other initiatives implemented
related to sports. Add rows if necessary.

Activities / Programs / Projects Date of Implementation

1. Training/ Coaching of athletes January 4, 2023
2. Selecting potential / Varsity players January 9, 2023
3.

Declaration:
I 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:
Sports Club Coordinator JUNE M. SADIWA
Signature
Date January 9, 2023

Certified by:
Principal/Officer-in-charge MYLENE M. FORTEZA
Signature
Date January 9, 2023

Verified by:
Division Sports Officer MAITA M. LAZARES
Signature

Date January 9, 2023

DAWIS ELEMENTARY SCHOOL

109928dawis@gmail.com
School ID: 109928
DAWIS ELEMENTARY SCHOOL
109928dawis@gmail.com
School ID: 109928
 Republic of the Philippines
Department of Education
MIMAROPA REGION
SCHOOLS DIVISION OF MARINDUQUE

DAWIS ELEMENTARY SCHOOL

109928dawis@gmail.com
School ID: 109928