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PFT FORM For FTP 2020-01

1. This 3-page physical fitness test document records an examinee's personal information, measurements, blood pressure, physician approval, and performance scores on pull-ups, sit-ups, push-ups, broad jump, 100m sprint, and a 3km jog. 2. The examinee's name, date of birth, age, badge number, office, raw scores, remarks, and scorer's signature are documented for each event. 3. Upon completion, the examinee and examiner sign and the assistant training manager notes the test.

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Julieto Resus
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1K views1 page

PFT FORM For FTP 2020-01

1. This 3-page physical fitness test document records an examinee's personal information, measurements, blood pressure, physician approval, and performance scores on pull-ups, sit-ups, push-ups, broad jump, 100m sprint, and a 3km jog. 2. The examinee's name, date of birth, age, badge number, office, raw scores, remarks, and scorer's signature are documented for each event. 3. Upon completion, the examinee and examiner sign and the assistant training manager notes the test.

Uploaded by

Julieto Resus
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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PHYSICAL FITNESS TEST

PSFTP CL 2020-01

Date Taken: __________________

Steps:
1. MEASUREMENT: Examiner’s Name/Initial:
Height: ________ Weight: _________ Waistline:___________ _____________________________
Chest: _____________ Result:_______________________

2. BP: 1st BP ______________ 2nd BP _____________ _____________________________

3. GO / No GO: ___________________________________
(Physicians Signature)

PHYSICAL FITNESS TEST FORM (Please write legibly)


Print Full Name: Last Name, First Name, MI RANK SEX

DATE OF BIRTH: AGE: PNP Badge Number:

OFFICE: (PSFTP TRAINING VENUE)

RAW REMARKS SCORER’S NAME


EVENTS RATING
SCORE Passed Failed & Signature
Pull-up/Hang

Sit-up

Push-up

Broad Jump

100 M Sprint

Jog (3 km)

TOTAL

_____________________________
(Examinee’s Signature)
Noted by:
____________________________
PMAJ CARLO C JURINARIO
Assistant Training Manager

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