FORM SSC.2 School Sports Club Attachment Form v1

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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: Volleyball Club
Established Date: September 20, 2024
Sports Club Facilitator/s: Marilou O. Lasaca
Sports Club Member/s:
Members’ Name Grade Level
1. Pajartin, Nigel C. 6
2. Labatigan, Klint John D. 6
3. Bodiongan, John Paul T. 6
4. Bodiongan, Prince Ivann L. 6
5. Bongcalon, John Nico 5
6. Omandam, Randyl J. 6
7. Derod, John Mark 6
8. Cerna, Arjun Andrie 5
9. Bendanillo, Orlando Jr. 5
10. Elga, Reniel 4
11. Carillo, Japhet Dave 5
12. Montaner, Jhon Rey

Sport’s Club Name: Volleyball Club


Established Date: September 20, 2024
Sports Club Facilitator/s: Marilou O. Lasaca
Sports Club Member/s:
Members’ Name Grade Level
1.Malaran, Janine S. 6
2.Bendanillo, Shanin L. 6
3.Villarta, Sopia M. 6
4.Lopez, Joylyn A. 6
5.Midel, Laiza C. 6
6.Oberez. Roelyn 4
7.Sanchez, Jennylyn 4
8.Taghap, Whisney 5
9.
10.

Sport’s Club Name: Chess Club


Established Date: September 20, 2024
Sports Club Facilitator/s: Marilou O. Lasaca
Sports Club Member/s:
Members’ Name Grade Level
1.Cris Angellou F. Sollano 4
2.Princess Marjery Lopez 5
3. Norjen Labadesos 4
4.Ellysa Labatigan 6

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


Telephone No.: (02) 632-9935; (02) 638-8525
II. PROGRAMMING
Put the preferred time schedule. Add rows and columns if necessary.
Time Sports Club Mon Tues Wed Thur Fri Sat
s
Example
3:00PM-4:00PM Volleyball Sports Club /
4:00PM-5:00PM Volleyball Sports Club /
5:00PM-6:00PM Chess Sports Club /

Put the preferred time schedule. Add rows and columns if necessary.
Time Varsity Club Mon Tues Wed Thur Fri Sat
s

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


Track and field oval
Gymnasium / covered court
Basketball court
Volleyball court
Swimming pool
Football/ softball/ baseball field
Spacious playing area
Others: ___________________
___________________
___________________

Sports Equipment Remarks

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


1.

2.

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


Telephone No.: (02) 632-9935; (02) 638-8525
3.

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
Marilou O. Lasaca
Coordinator
Signature
Date September 20,2024

Certified by:
Principal/Officer-in- Jerry T. Bation
Charge
Signature
Date September 20,2024

Verified by:
Ruel M. Fuerzas
Division Sports Officer

Signature
Date

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


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

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