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: BADMINTON CLUB
Established Date: August 1, 2023
Sports Club Facilitator/s: Glenda A. Matias
Sports Club Member/s: Israel E. Veniegas
Members’ Name Grade Level
Ayiesha Faye E. Estrella Grade 6
Kate Aliza Soriano Grade 6
Jerica Salcedo Grade 6
Ma. Celine Cayaban Grade 6
Jordan Remil B. Ibasco Grade 3
Rey Andro Manalo Grade 6
Francis Kyle Alqueza Grade 4
John Oliver Abagon Grade 3
Dominic Manalo Grade 6
Darren Clifford A. Matias Grade 4
Lorenzo Luis C. Elan Grade 6
Jeanlle S. Garcia Grade 6
Russel Sabdani Grade 6
Sport’s Club Name: CHESS CLUB
Established Date:
Sports Club Facilitator/s: Maria Homita F. Elan
Sports Club Member/s:
Members’ Name Grade Level
Francis D. Erguiza Grade 5
Roshane Kate Algaba Grade 5
Frayne Gian Fernandez Grade 5
Charles Jacob Morales Grade 5
Princess Angel Elan Grade 5
Francis Joseph D. Erguiza Grade 2
Sport’s Club Name: SEPAK TAKRAW LUB
Established Date:
Sports Club Facilitator/s: Alma B. Pansacula
Sports Club Member/s:
Members’ Name Grade Level
Kiefer Luis Ancheta Grade 4
Franz Christopher Doreza Grade 4
Czyan O. Mayor Grade 5
3F Mabini Building, DepEd Complex, Meralco Avenue, Pasig City
Telephone No.: (02) 632-9935; (02) 638-8525
Sport’s Club Name: ATHLETIC CLUB
Established Date:
Sports Club Facilitator/s: Jesus P. Angeles
Sports Club Member/s:
Members’ Name Grade Level
Jeanlle S. Garcia Grade 6
Lovely Ann Fermil Grade 6
Russel Sabdani Grade 6
John Mark Benito Grade 5
Gerald Y. Canosa Grade 4
John Rey Manaban Grade 4
Cris Jay Burgos Grade 5
Baness Mirador Grade 6
John Mark Oyando Grade 6
Kisha Mae Domicillo Grade 6
Allen M. Burgos Grade 5
II. PROGRAMMING
Put the preferred time schedule. Add rows and columns if necessary.
Time Sports Club Mon Tues Wed Thur Fri Sat
s
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
3F Mabini Building, DepEd Complex, Meralco Avenue, Pasig City
Telephone No.: (02) 632-9935; (02) 638-8525
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.
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
Coordinator
Signature
Date
Certified by:
Principal/Officer-in-
Charge
Signature
Date
Verified by:
Division Sports Officer ENCARNITA D. DEVERATURDA
Signature
Date
3F Mabini Building, DepEd Complex, Meralco Avenue, Pasig City
Telephone No.: (02) 632-9935; (02) 638-8525
