Coach's General Information

ATHELITIC MEET MUNICIPAL MEET

VENUE AROROY, MASBATE
DATE
COACH 1 INFORMATION
COACH : ROSEL R. RAMILO
SCHOOL : MATABA INTEGRATED SCHOOL
POSITION TEACHER I
AGE 34
GENDER FEMALE
DATE OF BIRTH NOVEMBER 28,1983
DATE OF ORIGINAL APPOINTMENT FEB. 2, 2016
EVENT TRIPLE JUMP
January 31, 2017
1/10/1994 8/20/2017

283
al Information

FORMATION

anuary 31, 2017

DAY-MONTH-YEAR AN FORMAT
 Republic of the Philippines
Department of Education
Region V
DIVISION OF MASBATE

CERTIFICATE OF EMPLOYMENT
(for DepEd Personnel)

Date

To Whom It May Concern:

This is to certify that Mr./Ms. ROSEL R. RAMILO is

presently employed in MATABA INTEGRATED SCHOOL as TEACHER I , since

FEB. 2, 2016 or for a period of 283 months.

This certification is issued upon the request of Mr./Mrs. ROSEL R. RAMILO

to coach in MUNICIPAL MEET

at AROROY, MASBATE .

School Head/ Administrative Officer

FOR PALARONG PAMBANSA ONLY

 (for DepEd Personnel)

(for Private School)

School Administrator/Official
School Head/ Administrative Officer
 Republic of the Philippines
Department of Education
Region V
DIVISION OF MASBATE
Rodeo Road, Masbate City

CERTIFICATION

This is to certifiy that ROSEL R. RAMILO completed the

twenty-four (24) hours sports training during the Division Accreditation for Coaches
on November 4-6, 2016 at Mobo North CS, Mobo, Masbate and Regional Seminar Training
on Coaching in Various Sports Disciplines on December 5-7, 2016 at Ibalong Centrum
for Recreation, Legazpi City.

Issued this 19th day of January 2017 at Masbate City, Philippines.

RUFINO B. ARELLANO
EPS-I/ Division School Sports Officer

FOR PALARONG PAMBANSA ONLY

 Republic of the Philippines
Department of Education
Region V
DIVISION OF MASBATE
Rodeo Road, Masbate City

CERTIFICATION

This is to certifiy that ROSEL R. RAMILO served

for at least one (1) year as coach/chaperone/trainer in TRIPLE JUMP

Issued this 19th day of January 2017 at Masbate City, Philippines.

RUFINO B. ARELLANO
EPS-I/ Division School Sports Officer

note: athletic manager nalang ang ma certify kun school, cluster, municipal and congresional district

FOR PALARONG PAMBANSA ONLY

 Republic of the Philippines
Department of Education
Region V
DIVISION OF MASBATE
Rodeo Road, Masbate City

CERTIFICATION

This is to certifiy that ROSEL R. RAMILO participated as

coach in the lower meets.

Issued this 19th day of January 2017 at Masbate City, Philippines.

RUFINO B. ARELLANO
EPS-I/ Division School Sports Officer

FOR PALARONG PAMBANSA ONLY

 Republic of the Philippines
Department of Education
Region V
DIVISION OF MASBATE
Rodeo Road, Masbate City

CERTIFICATE OF MEMBERSHIP

This is to certifiy that ROSEL R. RAMILO is an active

member of DEPED MASBATE SPED ASSOCIATION This
certificate also serves as recognition of his/her commitement to the development of
TRIPLE JUMP in the Division of Masbate Province.

Issued this 19th day of January 2017 at Masbate City, Philippines.

RUFINO B. ARELLANO
EPS-I/ Division School Sports Officer
Adviser

FOR PALARONG PAMBANSA ONLY

 Republic of the Philippines
Department of Education
Region V
DIVISION OF MASBATE
Rodeo Road, Masbate City

CERTIFICATE OF ACCREDITATION

This is to certifiy that ROSEL R. RAMILO is duly

accredited coach in TRIPLE JUMP and passed the Division Accreditation
for coaches on November 4-6, 2016 at Mobo North Central School, Mobo, Masbate.

Issued this 19th day of January 2017 at Masbate City, Philippines.

RUFINO B. ARELLANO
EPS-I/ Division School Sports Officer

FOR PALARONG PAMBANSA ONLY

 Republic of the Philippines
Department of Education
Region V
DIVISION OF MASBATE

M E D I CAL C E R T I FI CAT E
SEPTEMBER 20,2017
(Date)

To Whom It May Concern:

This is to certify that I have personally examined ROSEL R. RAMILO

Name
age 34 sex FEMALE born on NOVEMBER 28,1983 and have found that he/she is

physically fit, during the time of examination, to join and compete in the Lower Meets and

Palarong Pambansa.

Event: TRIPLE JUMP

Physical Examination

Date examined:

Height: Weight: Blood Pressure:

Pulse, Resting: Respiratory Rate:
Other Remarks:

Physician/Medical Officer
(Signature over printed name)
License No. :
PTR.:
Date:
Republic of the Philippines
City of ______________________)S.S.

SWORN STATEMENT

I ROSEL R. RAMILO , of legal age, single/married, with postal address at

, after having duly sworn in accordance with law hereby depose and state:

That I am presently employed with the MATABA INTEGRATED SCHOOL as

TEACHER I ;

That I have been employed in DEPED DIVISION OF MASBATE

since FEB. 2, 2016 or for a period of 283months. ;

That I was designated as coach of TRIPLE JUMP , who will participate in the
2017 Palarong Bikol;

That all the athletes are not members of the National Team, National Training Pool and Development
Pool receiving monthly stipend/allowance from the Philippine Sports Commission (PSC);

That all the athletes records submitted are true and correct to the best of my personal knowledge;

That all the athletes of TRIPLE JUMP , who will participate in the 2017 Palarong
Bikol are eligible;

That I execute this Affidavit to attest to the authenticity and veracity of all the documents submitted.

IN WITNESS WHEREOF, I have hereunto set my hand this day of JANUARY

2017 in Masbate City, Philippines.

Affiant

SUBSCRIBED AND SWORN TO before me this day of JANUARY , 2017

in Masbate City, Philippines, affiant exhibiting to me his/her Government issued ID/SSS/PRC/Philhealth, etc.
.

JOSE L. DONCILLO, CESO VI

Schools Division Superintendent

FOR PALARONG PAMBANSA ONLY

pwede man kag sir Roselier S. DelaPesa
Administrative Officer V
Republic of the Philippines
City of ______________________)S.S.

AFFIDAVIT

I ROSEL R. RAMILO , of legal age, single/married, with postal address at

, after having duly sworn in accordance with law hereby depose and state:

That I am presently employed with the MATABA INTEGRATED SCHOOL as

TEACHER I ;

That I have been employed in MATABA INTEGRATED SCHOOL

since FEB. 2, 2016 or for a period of 283months. ;

That I was designated as coach of TRIPLE JUMP , who will participate in the
2017 Palarong Bikol;

That all the athletes are not members of the National Team, National Training Pool and Development
Pool receiving monthly stipend/allowance from the Philippine Sports Commission (PSC);

That all the athletes records submitted are true and correct to the best of my personal knowledge;

That all the athletes of TRIPLE JUMP , who will participate in the 2017 Palarong
Bikol are eligible;

That I execute this Affidavit to attest to the authenticity and veracity of all the documents submitted.

IN WITNESS WHEREOF, I have hereunto set my hand this day of JANUARY

2017 in Masbate City, Philippines.

Affiant

SUBSCRIBED AND SWORN TO before me this day of JANUARY , 2017

in Masbate City, Philippines, affiant executing his/her Community Tax Certificate No.
issued at . on .

Notary Public

FOR PALARONG PAMBANSA ONLY