SPORTS-CLUB-SYSTEM - Table Tennis
SPORTS-CLUB-SYSTEM - Table Tennis
SPORTS-CLUB-SYSTEM - Table Tennis
Department of Education
BUREAU OF LEARNER SUPPORT SERVICES
SCHOOLS DIVISION OFFICE OF PANGASINAN II
INSTRUCTIONS: Input the necessary details. Indicate N/A if not applicable. DO NOT ABBREVIATE.
A. BASIC INFORMATION
Region I Division Pangasinan II
Name of School Carosucan Norte Elementary School School ID 101712
Address Carosucan Norte Asingan,
Pangasinan
Email address (if any) 101712@dep.gov.ph Telephone No.
1. Table Tennis
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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 no any misinterpretation made.
Prepared by:
Sports Club Coordinator Mary Ann V. Malala
Signature
Date 12/14/2023
Certified by:
Principal/Officer-in-Charge DR. NELIA O. ALBAY
Signature
Date 12/14/2023
Verified by:
Division Sports Officer ENRIQUE R. MACAYAN, EdD
Signature
Date
This form is not valid if not signed.
Required Attached document: Accomplished Form SSC.2 School Sports Club Attachment Form
Republic of the Philippines
Department of Education
BUREAU OF LEARNER SUPPORT SERVICES
SCHOOLS DIVISION OFFICE OF PANGASINAN II
Put the preferred time schedule. Add rows and columns if necessary.
Time Varsity Club Mon Tues Wed Thurs Fri Sat
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 no any misinterpretation made.
Prepared by:
Sports Club Coordinator Mary Ann V. Malala
Signature
Date
Certified by:
Principal/Officer-in-Charge Dr. Nelia O. Albay
Signature
Date
Verified by:
Division Sports Officer ENRIQUE R. MACAYAN, EdD
Signature
Date
This form is not valid if not signed.
Required Attached document: Accomplished Form SSC.2 School Sports Club Attachment Form