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 IVA- CALABARZON Divisio QUEZON
n n
Name of School NEW LITTLE BAGUIO ELEMENTARY School ID 165003
SCHOOL
Address BRGY. MAGSAYSAY, INFANTA, QUEZON
Email address (if 165003@[Link] Telephone 09302126330
any) No.
Website URL (if
any)
[Link] Profile
School Population 71
No. of Teaching Personnel: 4
No. of Athletes competed in the Division Meet: (Specify the event)0
Regional Meet: 0
Palarong Pambansa: 0
International Competition: 0
3F Mabini Building, DepEd Complex, Meralco Avenue, Pasig City
Telephone No.: (02) 632-9935; (02) 638-8525
[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.
[Link]
[Link]
[Link]
[Link]
5.
6.
C.2 Preferred Sports
Add rows if necessary.
[Link] [Link] TENNIS
[Link] [Link]
[Link] [Link] TAKRAW
[Link] [Link]
[Link] 11.
[Link] 12.
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
TESSA P. DE VELA
Coordinator
Signature
Date SEPTEMBER 10, 2024
Certified by:
Principal/Officer-in-
MARIFE OMNA R. PENAMANTE
Charge
Signature
Date SEPTEMBER 10, 2024
Verified by:
Division Sports Officer
Signature
Date
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
