Scribd
Upload
43 views5 pages

SSC.2 and Membership Certificate COACH

Sports Membership Form Sample

Uploaded by

The Stage
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
43 views5 pages

SSC.2 and Membership Certificate COACH

Sports Membership Form Sample

Uploaded by

The Stage
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
You are on page 1/ 5

Republic of the Philippines

Department of Education
BUREAU OF LEARNER SUPPORT SERVICES

3F Mabini Building, DepEd Complex, Meralco Avenue, Pasig City


Telephone No.: (02) 632-9935; (02) 638-8525
Republic of the Philippines
Department of Education
BUREAU OF LEARNER SUPPORT SERVICES
FORM SSC.2: School Sports Club Attachment Form

INSTRUCTIONS: 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.
Sport’s Club Name:
Established Date:
Sports Club Facilitator/s:
Sports Club Member/s:
Members’ Name Grade Level
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

3F Mabini Building, DepEd Complex, Meralco Avenue, Pasig City


Telephone No.: (02) 632-9935; (02) 638-8525
Republic of the Philippines
Department of Education
BUREAU OF LEARNER SUPPORT SERVICES

II. PROGRAMMING
Put the preferred time schedule. Add rows and columns if necessary.
Time Sports Club Mon Tues Wed Thurs Fri Sat
Example
3:00PM-4:00PM Arnis Sports Club /
4:00PM-5:00PM Chess Sports Club /
5:00PM-6:00PM Sepaktakraw Sports Club /

Put the preferred time schedule. Add rows and columns if necessary.
Time Varsity Club Mon Tues Wed Thurs Fri Sat

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


Track and field oval
Gymnasium / covered court
Basketball court
Volleyball court
Swimming pool
Football/ softball/ baseball field
Spacious playing area
Others:

Sports Equipment Remarks

3F Mabini Building, DepEd Complex, Meralco Avenue, Pasig City


Telephone No.: (02) 632-9935; (02) 638-8525
Republic of the Philippines
Department of Education
BUREAU OF LEARNER SUPPORT SERVICES

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.

2.

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 RAMONCITO P. HERMOGENES

Signature

Date SEPTEMBER 11, 2024

Certified by:
Principal/Officer-in-Charge MARIANITO S. VENTUCILLO JR.
Signature

Date SEPTEMBER 11, 2024

Verified by:
Division Sports Officer JAY-ARR C. TAYAO, DBA, EdD

Signature

Date SEPTEMBER 11, 2024


This form is not valid if not signed.

3F Mabini Building, DepEd Complex, Meralco Avenue, Pasig City


Telephone No.: (02) 632-9935; (02) 638-8525
Republic of the Philippines
Department of Education
BUREAU OF LEARNER SUPPORT SERVICES

REGION III
SCHOOLS DIVISION OF BULACAN
Schools Governance and Operations
Division School Sports Development
Program
NORTH HILLS VILLAGE ELEMENTARY SCHOOL
NORZAGARAY, BULACAN

This is to certify that

PATRICIA A. BALTAZAR
is an active member of the School Sports Club (BASKETBALL-SEC-GIRLS)
since August, S.Y. 2024-2025.

RAMONCITO P. HERMOGENES
Sports Coordinator

MARIANITO S. VENTUCILLO JR.


Principal IV

3F Mabini Building, DepEd Complex, Meralco Avenue, Pasig City


Telephone No.: (02) 632-9935; (02) 638-8525

You might also like