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Republic of the Philippines

Department of the Interior and Local Government


BUREAU OF FIRE PROTECTION
Regional Office IX
BFL Building, Fernan St., San Pedro, Pagadian City
Mobile Number: 09499969882
Email: emsr9region9@gmail.com

PHYSICAL AGILITY TEST FORM 2023

CODE No.: ______________________________ DATE: ___________________

I. Medical Passing Scores:

BODY TEMP: ___________ Men: 75%

BP: ___________ Women: 75%

EVENTS
NO. OF
POINTS
Applicant’s
SUPERVISED BY CHECKED/
REPETITIONS Initial Signature
OBSERVED BY

1. Pull-Ups

2. Full Arms Hanging


(Female)

3. Push-Ups

4. Sit-Ups

5.3K Endurance run


(Male)

6. 100-meter run
(Female)

7. Pick up and carry


on shoulder in full PPE
with 2.5” hose
(Male)

8. Pick up and carry


on shoulder in Full
PPE with 1.5” hose
(Female)

9. Pick up and carry in


Full PPE with a 50 Kg
load
(Male)

BFP9-PAT2023 Page 1/2


10. Pick up and carry
in Full PPE with a 25
Kg load
(Female)

TOTAL POINTS
NOTE: Unauthorized alterations, erasures and tampering of any entry on this form shall constitute
as grounds for disqualification.

Signature of Applicant

Concurred by: Noted by:

INSP ROBERT S SUYOM INSP MAR G RABAGO


Vice Chairman, PAT 2023 Chairperson, PAT 2023

BFP9-PAT2023 Page 2/2

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