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002 FORM SSC.2 School Sports Club Attachment Form v1new

The document is a School Sports Club Attachment Form from the Republic of the Philippines' Department of Education, detailing two sports clubs: the San Miguel Integrated School-Annex Athletics Club and Chess Club, both established in January 2023. It includes information on club facilitators, members, programming schedules, available sports equipment, and recent activities. The form is prepared and certified by school officials, ensuring the accuracy of the provided information.

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moralescarlvictor
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11 views

002 FORM SSC.2 School Sports Club Attachment Form v1new

The document is a School Sports Club Attachment Form from the Republic of the Philippines' Department of Education, detailing two sports clubs: the San Miguel Integrated School-Annex Athletics Club and Chess Club, both established in January 2023. It includes information on club facilitators, members, programming schedules, available sports equipment, and recent activities. The form is prepared and certified by school officials, ensuring the accuracy of the provided information.

Uploaded by

moralescarlvictor
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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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: SAN MIGUEL INTEGRATED SCHOOL-ANNEX ATHLETICS CLUB
Established Date: JANUARY 2023
Sports Club Facilitator/s: ADORACION A. BAUTISTA
Sports Club Member/s: ARMIELYN S. MARTIN
Members’ Name Grade Level
1.JANILYN MAE BATO 6
2.IAN CURT DENZEL GUZMAN 6
3.JAMIL N. GUZMAN 5
4.PRINCESS CARMEN BALAGOT 4
5.SHERWIN G. EDCHE 5
6.AUDREY LHEN T. SEBASTIAN 6
7.KRIZEL ANNE LOBBONG 4
8.XHIAN GABRIEL REYES 5
9.ROLANDO T. SEBASTIAN 4
10.EDLYN ROSE PASION 4
11.EMHIL PASION 4
12.JERALD LATUGAN 6
13.MARC ANGELO MANUEL 6
14.PRINCESS DIVINE VENTURA 5
15.FARIAH GRACE NAMINGIT 6
16.JEZARENE DOMINGO 6

Sport’s Club Name: SAN MIGUEL INTEGRATED SCHOOL-ANNEX CHESS CLUB


Established Date: JANUARY 2023
Sports Club Facilitator/s: MARY ROSE C. LADERAS
Sports Club Member/s: GLENDA O. EUGENIO
Members’ Name Grade Level
1.MARK DANE PINTO 6
2.JOHN PAUL BAD-ANG 5
3.QUEEN CARLA BALAGOT 5
4.PRINCESS DIVINE VENTURA 5
5.JIMMERSON GUTIEREZ 5
6.
7.
8.
9.
10.

Sport’s Club Name:


Established Date:
Sports Club Facilitator/s:
Sports Club Member/s:

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


Telephone No.: (02) 632-9935; (02) 638-8525
Members’ Name Grade Level
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

II. PROGRAMMING
Put the preferred time schedule. Add rows and columns if necessary.
Time Sports Club Mon Tues Wed Thurs Fri Sat
Example
3:00-4:00PM SMIS-ANNEX ATHLETIC 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


N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Others: ___________________
___________________
___________________

Sports Equipment Remarks


ARNIS
N/A
N/A
N/A
N/A
N/A
N/A
N/A
SEPAK TAKRAW
N/A
N/A

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


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

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


SMIS-ANNEX ATHLETIC CLUB JANUARY 2023

SMIS-ANNEX CHESS CLUB JANUARY 2023

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 HARRY JAY G. CEZAR
Signature
Date October 28, 2024

Certified by:
Principal/Officer-in-Charge DIOMAR A. LUCERO

Signature
Date October 28, 2024

Verified by:
Division Sports Officer MANOLO Y. BAGUNU

Signature
Date October 28, 2024

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


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

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