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
Region V Divisio ALBAY
n
Name of School BATAN NATIONAL HIGH SCHOOL School ID 301813
Address Purok 2, Batan, Rapu-Rapu, Albay
Email address (if any) [email protected] Telephone No. 09507785059
Website URL (if any)
B. School Profile
Enrolment : 221
No. of Teachers : 9
No. of Non – Teaching Personnel : 1
Athletics : 10
Volleyball : 11
Basketball : 12
DanceSports : 16
Badminton : 8
Swimming : 11
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.Swiming
2.Athletics
3.Dance SPORTS
4.
5.
6.
C.2 Preferred Sports
Add rows if necessary.
1. Swimming 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 Coordinator CASIANO P. CANCISIO
Signature
Date
Certified by:
Principal/Officer-in-Charge ARLENE B. YANZON
Signature
Date
Verified by:
Division Sports Officer DANILO R. MURILLO
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