FORM SSC.1 School Sports Club Registration Form v1

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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 IV-MIMAROPA Division MARINDUQUE

Name of School MENDEZ ELEMENTARY SCHOOL School ID 109951

Address MENDEZ, MOGPOG, MARINDUQUE

Email address (if any) [email protected] Telephone No.

Website URL (if any)


B. School Profile
Mendez Elementary School is a complete elementary school in the District of Mogpog. It is located
at Barangay Mendez, Mogpog, Marinduque which is accessible by all means of transportation. The school
caters elementary curriculum which implements K to 12 Basic Education Program. Mendez Elementary
School is a Child-Friendly School which adheres faithfully and relidiously with the Child Protection Policy
and Anti-Bullying Campaigns.
The school is headed by an Officer-In Charge with Seven (7) nationally-funded teaching personnel.
Out of the 8 regular-permanent teachers, including the Officer In-Charge, there is one (1) Teacher II, and
seven (7) Teacher I.

As of August 31,2022. The school has a total enrolment of 126 learners from Kindergarten to
Grade VI, based on the Learners Enrolment Survey Form (LESFs) in both remote and online enrolment
conducted during the enrolment period, composed of 71 males and 55 females. From this enrolment, there
are 46 learner- athletes who joined the different sports club composed of 34 males and 12 females.

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. Chess
2. Athletics
3.
4.
5.
6.

C.2 Preferred Sports


Add rows if necessary.
1. Basketball 7.
2. Volleyball 8.
3. Table Tennis 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 JOSE ROMMEL M. MACUNAT
Signature
Date JANUARY 30, 2023

Certified by:
Principal/Officer-in-Charge ROWENA L. MACUNAT
Signature
Date JANUARY 30, 2023

Verified by:
Division Sports Officer MAITA M. LAZARES
Signature
Date JANUARY 30, 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

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