BUREAU OF LEARNER SUPPPORT 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 III Division Nueva Ecija
Little Child Jesus Christian
Name of School School ID 419027
Academy Cabiao, Nueva Ecija, Inc.
Address Duhat Street, Polilio, Cabiao, Nueva Ecija
Email Address (if
lcjcarecords@yahoo.com Telephone No. (044)3405-777
any)
Website URL (if
N/A
any)
B. School Profile
Little Child Jesus Christian Academy Cabiao, Nueva Ecija, Inc. (LCJCA) was conceptualized by a group
of friends spearheaded by Mr. Alejo F. Santos who eventually became the Chairman/President of the corporation. The
Little Child Jesus was named after the patron Saint of the Barangay Polilio where the school was erected. Mr. Santos
initially dreamt of putting up a simple school of sports and tutorial center but after the initial meeting that happened in
June 12, 2004, it was decided to put up a corporation that would run the operation of a private school.
In September 7, 2004 Little Child Jesus Center of Learning, (LCJCL) Cabiao, N. E. Inc. received the
Certificate of Registration from Securities and Exchange Commission (SEC) and complied all the requirements in
Department of Education (DepEd) for the opening of Pre-Elementary Course. On January 15, 2005 held the
groundbreaking ceremony by the Board of Directors and started of its construction of Two-Storey building. The Little
Child Jesus Center of Learning started with seventy-five (75) learners on its first year of operation for School Year
2005-2006. The next academic year the population increased more than twice to 168.
The Pre-Elementary Course was recognized in September 7, 2007 with Government Recognition No. E-
077 s. 2007. The Government Recognition No. E-011 s. 2011 was given to the Grade I - VI of Elementary Course in
March 8, 2011. In line with the opening of its Secondary Course, the name Little Child Jesus Center of Learning
LCJCL was changed to Little Child Jesus Christian Academy (LCJCA) Cabiao, Nueva Ecija, Inc.. In April 6, 2015 the
Grade 7 to Grade 10 of Secondary Course was recognized under Government Recognition No. S-009 s. 2015.
Little Child Jesus Christian Academy Cabiao, Nueva Ecija, Inc. strives to create a positive and transformative
educational experience for all learners, equipping them to learn, live, and lead to become servant leaders of tomorrow
and be globally competitive community.

PHILOSOPHY
Learn. Live and Lead.
The emblem of LCJCL consist of an equilateral triangle symbolizes the Bible and the Cross
at the center and the 2004 was the year it was founded. The letterings using
copperplategothicbold represents the stability of the institution. The design enclosed with
four-sided equal border which means equality and fairness. This signifies the perpetual
commitment of the school to provide high quality education and services to its clienteles and
to uplift their living values and develop vigorous relationship with God and others. The logo
traced the acronyms LCJCL based from the word “TAPAT” that when we read backward also
the same, letter J stands for Jesus as the center of our faith as Jesus said, “Let the little
children come to me, and do not hinder them, for the kingdom of God belongs to such as
these.” - Matthew 19:14.

3F Mabini Building, DepEd Complex, Meralco Avenue, Pasig City

Telephone No.: (02) 632-9935; (02) 638-8525
 OUR MISSION: LEARN to excel. LIVE with compassion. LEAD to build a globally competitive individual

OUR VISION: Little Child Jesus Christian Academy, Cabiao, Nueva Ecija, Inc. commits itself in developing servant
leaders and globally competent individuals who are responsive to the aspirations of the society.

C. Sports Club
C.1 Mandatory Sports
At least three out of nine mandatory sports; however, you may establish any preferred sports club.
1. Badminton 7. Dance Sports
2. Table Tennis 8. Taekwondo
3. Sepaktakraw 9. Track and Field
4. Volleyball
5. Basketball (3X3)
6. Chess

C.2 Preferred Sports

1. Badminton 5. Chess
2. Table Tennis 6. Dance Sports
3. Sepaktakraw 7. Taekwondo
4. Volleyball 8. Basketball

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 MICHELLE L MUYOT
Signature
Date October 16, 2023
Certified by:
School Principal FERNANDA M. SANTOS, MAVEd
Signature
Date October 16, 2023
Verified by:
District Sports Officer JERWIN SOLIMAN GALANG, PhD
Signature
Date

Division Sports Coordinator JOEL VICTORIO CRUZ

Signature
Date

Schools Division Superintendent Eng’r. EDGARD C. DOMINGO, PhD, CESO V

Signature
Date

This form is not valid if not signed.

3F Mabini Building, DepEd Complex, Meralco Avenue, Pasig City

Telephone No.: (02) 632-9935; (02) 638-8525
Required Attached Documents: Accomplished Form SSC 2 School Sports Club Attachment Form

BUREAU OF LEARNER SUPPPORT 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: JC Badminton Club
Established Date: September 29, 2023
JC Badminton Club President: TORRES, Kenneth P.
JC Badminton Club Vice President: MIRANDA, Yuan Kyle E.
JC Badminton Club Secretary: TORRES, Aljur P.
JC Badminton Club Treasurer: MENDOZA, Christian Gabriel M.
Members’ Name Grade Level
1. OMIRAY, Jayross L. Grade-7
2. ANABU, Symon Steaven C. Grade-7
3. VELASQUEZ, Mark James P. Grade-7
4. GUEVARRA, Raymond Jash G. Grade-7
5. ENDITA, Kaizen S. Grade-8
6. RAMOS, John Cedrict M. Grade-8
7. PEROS, Benedict John L. Grade-9
8. MARIANO, John Carlo Grade-11
9.
10.

Sport’s Club Name: LC Badminton Club

Established Date: September 29, 2023
LC Badminton Club President: JOSON, Zaira Mari C.
LC Badminton Club Vice President: SANTOS, Jonina A.
LC Badminton Club Secretary: MANUEL, Maria Francesca V.
LC Badminton Club Treasurer: MARUNDAN, Yukari Rose A.
Members’ Name Grade Level
1. ESPANTO, Crystal Aye Raine V. Grade-8
2. MEJIA, Annica Sofia C. Grade-7
3. PONGCO, Shanelle S. Grade-7
4. LOPEZ, Miriam Jade D. Grade-7
5. OCAMPO, Allyza Rosalie R. Grade-7
6. ORTIZ LUIS, Chancesca P. Grade-8
7. BAGAN, Alojah Jhennine M. Grade-7
8. ANTONIO, Genesis Reign B. Grade-7
9. SABINO, Kathleen Joy F. Grade-7
10.

3F Mabini Building, DepEd Complex, Meralco Avenue, Pasig City

Telephone No.: (02) 632-9935; (02) 638-8525
 Sport’s Club Name: LC Sepaktakraw Club
Established Date: October 6, 2023
LC Sepaktakraw Club President: MUNGCAL, Aile Khazmere N.
LC Sepaktakraw Club Secretary: VIERNES, Princess Marie P.
Members’ Name Grade Level
1. MONTAÑO, Jillian Mae V. Grade-7
2. MANABAT, Princes Chloe Chantal P. Grade-7
3. LUCAS, Angel Luz Y. Grade-7
4. MENDOZA, Amira B. Grade-7
5. ALAVE, Ronnea Mae M. Grade-8
6. JOSON, Zaira Mari C. Grade-9
7. CABUG, Rhaizel Lian R. Grade-9
8. SALE, Cassandra C. Grade-9
9. SAMONTE, Jheana Dane N. Grade-9
10. DELA PEÑA, Angel Chloe N. Grade-7

Sport’s Club Name: JC Sepaktakraw Club

Established Date: October 6, 2023
JC Sepaktakraw Club President: AQUINO, Aeron Joshua L.
JC Sepaktakraw Club Secretary: DAYAO, John Raniel L.
Members’ Name Grade Level
1. PAGUINTO, Christian Hanzen P. Grade-10
2. SUBA, Erlhix Jhiro V. Grade-8
3. SUBA, Leonard Eric V. Grade-7
4. OCAMPO, Jerry Noah V. Grade-7
5. SINCERO, Kian Charles G. Grade-7
6. OJANOLA, Joshua L. Grade-8
7. DE LEON, Christopher Zairen P. Grade-8
8. RIDAO, Caleb Josh J. Grade-7
9. AQUINO, Andrei Erome L. Grade-9
10. OMIRAY, Jayross L. Grade-7

Sport’s Club Name: JC Basketball Club

Established Date: October 6, 2023
Team Captain: GUEVARRA, Mari Klein Stoef G.
Assistant Team Captain: CLOSA, Christian Andrei C.
Members’ Name Grade Level
1. LAPUZ, Mark Anthony M. Grade-7
2. PARUNGAO , Marco Llevi R. Grade-7
3. BASSI, Lian Paulo S. Grade-7
4. ANDRES, Juan Miguel R. Grade-7
5. BAUTISTA, Sean Adrian T. Grade-9
6. CLEMENTE, Josh Harvey S. Grade-9
7. MALLARI, Charls Luiz M. Grade-10
8. MENDOZA, Aeron B. Grade-10
9. MANLUSOC, Jamez Timothy S. Grade-10
10. SANTIANO, Kristoffer Jumong M. Grade-10

3F Mabini Building, DepEd Complex, Meralco Avenue, Pasig City

Telephone No.: (02) 632-9935; (02) 638-8525
 Sport’s Club Name: LC Volleyball Club
Established Date: October 13, 2023
Team Captain: MANGILIT Lorein D.
Assistant Team Captain: TUICO Jahna Samantha Shane V.
Members’ Name Grade Level
1. DE ROXAS, Alexa Rhiel M. Grade-7
2. DELA PEÑA, Angel Chloe N. Grade-7
3. DIZON, Athena Mae R. Grade-7
4. ALCOS, Carla Nicole F. Grade-8
5. ALCOS, Carleen Nicole F. Grade-8
6. PANEDA, Ma. Patricia D. Grade-8
7. PARUNGAO, Gean Nickole H. Grade-8
8. SABINO, Kate Jhazmine F. Grade-8
9. TABOSO, Althea Vianca C. Grade-8
10. MABALOT, Abigail Lara P. Grade-10
11. SALE, Cassandra C. Grade-10
12. PARUNGAO, Rhay Anne M. Grade-10
13. TAGUINOD, Jeffa Lidez C. Grade-11

Sport’s Club Name: JC Volleyball Club

Established Date: October 13, 2023
Team Captain: MACATULA, Jarel Dheil M.
Assistant Team Captain: CRUZ, Mark Lawrence B.
Members’ Name Grade Level
1. CLOSA, Christian Andrei C. Grade-9
2. PALON, Elbert Jhes L. Grade-9
3. MIRANDA, Yuan Kyle E. Grade-10
4. DEL ROSARIO, Lorenzo Joaquin F. Grade-10
5. MANLUSOC, Jamez Timothy S. Grade-10
6. GUEVARRA, Mari Klein Stoef G. Grade-10
7. MEJIA, Jairuz Anjelo F. Grade-10
8. VALDEZ, Ron Aejhon S. Grade-7
9. CASTRO, Aaron Jireh F. Grade-8
10. VINUYA, Onesimus L. Grade-7
11. PALMA, Cedric B. Grade- 10
12. BAUTISTA, Stan Andrei T. Grade- 10

Sport’s Club Name: JC and LC Table Tennis

Established Date: October 6, 2023
JC Table Tennis Club President: MEJIA, Jairuz Anjelo F.
LC Table Tennis Club Secretary: MUNGCAL, Aile Khazmere N.
Members’ Name Grade Level
1. MILLARES, Princess Angela C. Grade-10
2. MANGUNDAYAO, Ephraim Jeremiah O. Grade-9
3. MIRANDA, Nathan Alley O. Grade-8
4. DAYAO, John Raniel L. Grade-8
5. AQUINO, Aeron Joshua L. Grade-8
6. GOMEZ, Lera Yheitz M. Grade-9

3F Mabini Building, DepEd Complex, Meralco Avenue, Pasig City

Telephone No.: (02) 632-9935; (02) 638-8525
 7.
8.
9.
10.
Sport’s Club Name: LC Chess Club
Established Date: October 6, 2023
LC Chess Club President: ROBLES, Raiza Charice M.
LC Chess Club Secretary: DIAZ, Juliana Therese D.
Members’ Name Grade Level
1. CACAYORIN, Jezendale Princess N. Grade-7
2. CANUEL, Marthina Eunice C. Grade- 7
3. SAMONTE, Jheana Dane N. Grade-9
4. NIDAR, Sairah Gwen A. Grade-10
5. CADUCO, Niña Alexa M. Grade-10
6. PLANTILLA, Deana Alexa L. Grade-10
7.
8.
9.
10.

Sport’s Club Name: JC Chess Club

Established Date: October 6, 2023
JC Chess Club President: FAJARDO, John Elijah B.
JC Chess Club Secretary: RIBO, Salm Joash F.
Members’ Name Grade Level
1. REYES, Dwayne Matthew B. Grade-10
2. BAUTISTA, Stan Andrei T. Grade-10
3. MIRANDA, Eliezar A. Grade-10
4. VELASCO, Ethan P. Grade-10
5. MANAHAN, Von Moises D. Grade-9
6.
7.
8.
9.
10.

II. PROGRAMMING

A. GRADE SCHOOL

Time Sports Club Mon Tues Wed Thurs Fri Sat

LC & JC Badminton Club / / /
LC & JC Table Tennis Club / / / / /
LC & JC Sepaktakraw Club / / /
3:30 – 5:30
LC & JC Volleyball Club / / / / /
LC & JC Basketball Club / / / / /
LC & JC Chess Club / / / / /

3F Mabini Building, DepEd Complex, Meralco Avenue, Pasig City

Telephone No.: (02) 632-9935; (02) 638-8525
 LC & JC Dance Sports Club / / /
5:30 – 7:00 LC & JC Taekwondo Club Sat. 10:00 – 12:00 / /
B. HIGH SCHOOL
Time Sports Club Mon Tues Wed Thurs Fri Sat
LC & JC Badminton Club / / /
LC & JC Table Tennis Club / / / / /
LC & JC Sepaktakraw Club / / /
6:45 – 8:30 LC & JC Volleyball Club / / / / /
LC & JC Basketball Club / / / / /
LC & JC Chess Club / / / / /
LC & JC Dance Sports Club / / /
5:30 – 7:00 LC & JC Taekwondo Club Sat. 10:00 – 12:00 / /

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
Sepak Takraw Court Badminton Courts convert to Sepak Takraw
MOA with Sangguniang Barangay of Polilio to use
Basketball Court
the Umali Gymnasium for practices and games
Volleyball Court With Standard Size Volleyball Court
Badminton Court One court for Girls and One for Boys
Table Tennis Three Sets for playing and One set for many balls
Spacious Playing Area For Table Tennis and Chess
Others:

Sports Equipment Remarks

Robo Pong for many balls
4 Sets of Table Tennis with Net In good condition
6 Sets of Paddle with Rubbers In good condition
4 Takraw balls for boys In good condition
2 Takraw balls for girls In good condition
6 Basketball In good condition
8 Volleyball In good condition
6 Badminton Rackets In good condition
Volleyball, Badminton Net In good condition
8 Chess Board In good condition
4 Chess Mat In good condition
Shot Put, Disscuss & Javelin In good condition
4 Game of the Generals In good condition
8 Word Factory In good condition
2 Tennis Racket In good condition
2 Chess Timer In good condition

3F Mabini Building, DepEd Complex, Meralco Avenue, Pasig City

Telephone No.: (02) 632-9935; (02) 638-8525
 Wishles, Stop Watch In good condition

IV. SPORTS ACTIVITIES, PROGRAMS AND/OR PROJECTS

Give at least (3) three recent activities, programs, projects or any other initiatives related to sports.

Activities / Programs/ Projects Date of Implementation

1. Open Try-out for Badminton Boys and Girls First Week of September
2. Badminton Ranking for Officer’s Position First Week of October
3. Open Try-out for Sepaktakraw Boys and Girls First Week of October
4. Intramural Meet October 24, 25 and 26, 2023

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 MICHELLE L MUYOT
Signature
Date October 16, 2023

Certified by:
School Principal FERNANDA M. SANTOS, MAVEd
Signature
Date October 16, 2023

Verified by:
District Sports Officer JERWIN SOLIMAN GALANG, PhD
Signature
Date

Division Sports Coordinator JOEL VICTORIO CRUZ

Signature
Date

Schools Division Superintendent Eng’r. EDGARD C. DOMINGO, PhD, CESO V

Signature
Date

3F Mabini Building, DepEd Complex, Meralco Avenue, Pasig City

Telephone No.: (02) 632-9935; (02) 638-8525