Republic of the Philippines
Department of Education
BUREAU OF LEARNER SUPPORT SERVICES
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
Regio III Divisio SDO PAMPANGA
n n
Name of School CAMACHILE ELEMENTARY SCHOOL School ID 105982
Address SITIO CAMACHILE, FLORIDABLANCA, PAMPANGA
Email address (if Telephone 09072847770
any) No.
Website URL (if
any)
[Link] Profile
Camachile Sports Club
CAROL V. ALMACEN Elementary School Heaf
WRAYETH OBREY G. SUPAN Teacher I/ School Sports Coordinator/ School Sports Club
Coordinator
KIM NICOLE C. SAMPANG Teacher I/ Sports Club Facilitator
SARRAH S. MANGILIMAN Teacher I/ Sports Club Facilitator (Athletics )
KIM NICOLE C. SAMPANG Teacher I / Sports Club Facilitator ( Badminton )
ERLINDA R. SAPAULA Teacher I / Sports Club Facilitator ( Arnis)
[Link] 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. ARNIS
[Link]
[Link]
[Link] TAKRAW
[Link]
[Link] SPORTS
C.2 Preferred Sports
Add rows if necessary.
[Link]
[Link]
[Link]
3F Mabini Building, DepEd Complex, Meralco Avenue, Pasig City
Telephone No.: (02) 632-9935; (02) 638-8525
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
WRAYETH OBREY G. SUPAN
Coordinator
Signature
Date NOV. 9, 2022
Certified by:
Principal/Officer-in-
CAROL V. ALMACEN
Charge
Signature
Date NOV.9, 2022
Verified by:
Division Sports Officer JANE P. VALENCIA,EdD
Signature
Date NOV. 9, 2022
This form is not valid if not signed.
Required Attached Document: Accomplished Form SSC.2 School Sports Club Attachment Form
3F Mabini Building, DepEd Complex, Meralco Avenue, Pasig City
Telephone No.: (02) 632-9935; (02) 638-8525
