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 V - Bicol Divisio SDO Masbate Province
n n
Name of School CABAS-AN ELEMENTARY SCHOOL School ID 113400
Address CABAS-AN, AROROY, MASBATE
Email address (if Telephone None
any) No.
Website URL (if N/A
any)
B.School Profile
The Cabas-an Elementary School was established in 1975. Since its establishment, the school was a
consistent performer not only in sports but in academics as well.
The school is now handled by a School Head who relentlessly supports our chosen sport. Armed
with very supportive division sports officials headed by Sir Rufino B. Arellano and equally qualified
teacher/coaches, we can now be assured of a greater chance of victory in our sports endeavours, not
only in our division but also in regional, national and even international competitions.
3F Mabini Building, DepEd Complex, Meralco Avenue, Pasig City
Telephone No.: (02) 632-9935; (02) 638-8525
C.Sports 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.Football
2.Badminton
3.Athletics
4.
5.
6.
C.2 Preferred Sports
Add rows if necessary.
1. 7.
2. 8.
3. 9.
4. 10.
5. 11.
6. 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
BERNADETH P. LEGASPINO
Coordinator
Signature
Date January 12, 2023
Certified by:
Principal/Officer-in- RYAN G. BELLO
Charge
Signature
Date January 12, 2023
Verified by:
Division Sports Officer RUFINO B. ARELLANO
Signature
Date January 12, 2023
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
LIST OF FOOTBALL PLAYERS
1.LORENCE G. PANGANIBAN
2. JOMENICK V. RAMILO
3. RODGIE R. TOMLOD
4. JOREN T. GERSANIBA
5. KENTH RAVEN O. GERSANIBA
6. JEMIR L. TOMLOD
7. MATTHEW L. GOMEZ
8. PRINCE IMELJAN M. CAPINIG
9. WENNIE FRED L. GOMEZ
10.THIRD JHON L. GOMEZ
BADMINTON
1.KYLA JOBELLE G. NARCISO
2. JUANA JOY M. SATUMBA
ATHLETICS
RUNNING
1. MYRA T. BORABO(GIRLS)
2. DANAO, RAZELL(BOYS)
3F Mabini Building, DepEd Complex, Meralco Avenue, Pasig City
Telephone No.: (02) 632-9935; (02) 638-8525