Republic of the Philippines
Department of Education
Region I
SCHOOLS DIVISION OFFICE I PANGASINAN
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
I
Division
Name of School
Address
TONDOL ELEMENTARY SCHOOL
SCHOOLS DIVISION OFFICE I
PANGASINAN
School ID
101221
TONDOL, ANDA, PANGASINAN
Email address (if any)
Website URL (if any)
101222@r1.deped.gov.ph
Telephone No.
www.tondoles.com
B. School Profile
Classification of School: Kindergarten to Grade 6
Class Organization :
Mono-Grade
School Address: TONDOL, ANDA, PANGASINAN
District:: ANDA
Number of Enrolment SY 2022-2023: 318
School Head: Cezardo C. Ladia’
Number of Teaching Personnel: 14
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.
2.
3.
4.
5.
6.
Softball
Baseball
Athletics (Throws, Jumps, Runs) boys and Girls
Basketball
Sepak Takraw
Badminton (Boys and Girls)
C.2 Preferred Sports
Add rows if necessary.
1.
2.
3.
4.
5.
6.
Softball
Baseball
Athletics (Jumps, throws, runs)
Basketball
Sepak Takraw
Badminton
Address: Alvear St. Lingayen, Pangasinan
Telephone No.: (075)-522-2202
Email: pangasinan1@deped.gov.ph
7.
8.
9.
10.
11.
12.
Page No.: Page 1 of 2
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
REBECCA G. ABAR
January 20, 2023
Certified by:
Principal/Officer-in-Charge
Signature
Date
Verified by:
Division Sports Officer
Signature
Date
CEZARDO C. LADIA, EdD
January 20, 2023
DULCE D. TOLOSA, ALDRIN C. OCSAN
This form is not valid if not signed.
Required Attached Document: Accomplished Form SSC.2 School Sports Club Attachment Form
Address: Alvear St. Lingayen, Pangasinan
Telephone No.: (075)-522-2202
Email: pangasinan1@deped.gov.ph
Page No.: Page 2 of 2