Republic of the Philippines CAMIGUIN POLTECHNIC STATE COLLEGE Balbagon, Mambajao, Camiguin Tel/Fax (088) 387-0044, (088) 387-1268,

(loc.119) INSTITUTE OF ENGINEERING AND COMPUTER STUDIES

STUDENTS TRAINEES PERSONAL DATA SHEET

I. PERSONAL DETAILS
Name: Course and Year: Present Address: Date of Birth: Place of Birth: Height: Weight: Sex: Age: Civil Status: Language/Dialect Spoken: Contact Number, if any:

II.

FAMILY BACKGROUND
Father: Occupation: Mother: Occupation: No. of Brother(s): No. of Sister(s): Guardian while studying in CPSC: Relationship: Address:

III.

SCHOLASTIC BACKGROUND

High School where Graduate: Year: Address: Honors/Distinction received: IV. Person to be Notified in Case of Emergency: Name: Address: Telephone/Cell No: ___________________________________________ Signature of Student Trainee

Republic of the Philippines

CAMIGUIN POLYTECHNIC STATE COLLEGE

Balbagon,Mambajao,Camiguin Tel/Fax (088) 387-0444, (088) 387-1268, (loc. 119) INSTITUTE OF ENGINEERING AND COMPUTER STUDIE

TRAINEES-INDUSTRY AGREEMENT AND LIABILITY WAIVER

TO WHOM IT MAY CONCERN,

THIS IS TO CERTIFY THAT I, a major in senior student of this college has been granted permission by the college administration to undergo On-The-Job Training at theform to

Further, I hereby voluntarily agree to undergo the said training in the above mentioned company/agency/firm in order to acquire actual industry experiences with the following terms and conditions, that, 1. I shall bide the companys rule and regulations and shall comply with the imposed requirements for the On-The-Job Training (OJT) otherwise; I shall be excluded from further participation. 2. There is no employer-employee relationship between the company and me. 3. I shall exercise care and diligence in any task aligned to me. 4. I shall be made answerable/liable for the damages to property or injury to third persons that may be occasioned by y intentional or neglect acts while in the course of training. 5. The firm or industry is not held liable/answerable for any accident that may occur while performing my OJT work, unless otherwise, the firm or industry will extend financial assistance to the concerned trainee. Signed this ___ day of ____, 2012 at Camiguin Polytechnic State College, Balbagon, Mambajao, Camiguin, Philippines.

________________________ (Signature over Printed Name) With Consent and Approval: _________________________________________ (Signature over Printed Name of Parents/Guardian)

ENGR. JOSELITO O. DAROY Institute OJT In-charge

Republic of the Philippines CAMIGUIN POLTECHNIC STATE COLLEGE Balbagon, Mambajao, Camiguin Tel/Fax (088) 387-0044, (088) 387-1268, (loc.119) INSTITUTE OF ENGINEERING AND COMPUTER STUDIES

EVALUATION OF THE ON-THE-JOB TRAINING (OJT) STUDENT TRAINEE

Name of Traine:______________________________Specialization:______________________ Name of Cooperating Agency/Company:. Address: . Department/Section Head: _______________________________________________________ Inclusive Dates of training from: _______________________To: _________________________

Please rate the trainees On The Job Training in your company/ agency using the scale a follows: 9 - 10 Outstanding 3 - 5 Fair 7 - 8 Very Satisfactory 1 - 2 Poor 5 - 6 Satisfactory

JOB FACTORS 1. Attendance and Punctually (Regular and punctual in reporting to work). 2. Dependability, Reliability and Resourcefulness (Ability to work with minimum supervision). 3. Cooperation (Works well with everyone, good team worker). 4. Personality (Personal grooming and pleasant disposition, shares opinion, ideas and talent with others, friendly). 5. Job knowledge (Mastery and understanding of all phases of jobs and observe safety habits). 6. Speed of work (Able to compete work in allotted time). 7. Quality of work (Thoroughness, accuracy, neatness and effectiveness). 8. Judgment (Sound decision, ability to identify and evaluate pertinent factors). 9. Job Attitude (Exceptional interest with is work, always physically fit and busy). 10. Initiative (Ability to attack own and others problem with drive force, Makes exceptionally worthwhile suggestions). TOTAL POINTS Evaluated by:

RATINGS

___________________________________________ Signature over Printed Name of Supervisor/ Foreman

___________________ Date

Republic of the Philippines CAMIGUIN POLYTECHNIC STATE COLLEGE Balbagon,Mambajao,Camiguin Tel/Fax (088) 387-0444, (088) 387-1268, (loc. 119)

March 28, 2012

ENGR. JOSELITO P. ABAMONGA Head district 3, MOM NGCP Carmen, Cagayan De Oro City, Misamis Oriental, Philippines

Sir/Maam:

Greetings! The Camiguin Polytechnic State College (CPSC) of the Province of Camiguin would like to establish partnership with your office in developing competent individuals who are enrolled in Bachelor of Science in Electrical Engineering. The OJT student will undergo 240 hours this summer (April to May 2012). Your kind accommodation of our OJT would be of truly great help to put into practice their learning in the classroom. Thank you very much and more power.

Very truly yours,

JOSELITO O. DAROY, REE, M.Eng

OJT-Coordinator

Approved:

VENUS IRVING LAMMAWIN, Ed. D College President

Republic of the Philippines CAMIGUIN POLYTECHNIC STATE COLLEGE Balbagon, Mambajao, Camiguin Tel/Fax (088) 387-0044, (088) 387-1268, (loc.119) INSTITUTE OF ENGINEERING AND COMPUTER STUDIES

March 19, 2013

PASTOR ABREGANA, PEE PULANGI Kiuntod, Maramag, Bukidnon

Sir:

Greetings! We are pleased to recommend these students taking up BACHELOR OF SCIENCE IN ELECTRICAL ENGINEERING, to undergo On-the-job Training (OJT) in your establishment this summer (April to May 2012). This training is required as part of their curriculum. Critelyn P. Lera LeonilCris P. Visto Mark Anthony M. Oyan

Your assistance to the trainee during the training period will be of significance to her advancement in her field. The OJT is required to render 240 hours in your establishment.

Thank you very much and more power.

Very truly yours,

ENGR. JOSELITO O. DAROY OJT-Coordinator

Approved:

ENGR. GIL B. SALAS Institute Head-IECS

VENUS IRVING LAMMAWIN, Ed. D College President

Republic of the Philippines CAMIGUIN POLYTECHNIC STATE COLLEGE Balbagon, Mambajao, Camiguin Tel/Fax (088) 387-0044, (088) 387-1268, (loc.119) INSTITUTE OF ENGINEERING AND COMPUTER STUDIES

STUDENTS TRAINEES PERSONAL DATA SHEET

V. PERSONAL DETAILS
Name: Course and Year: Present Address: Date of Birth: Place of Birth: Height: Weight: Sex: Age: Civil Status: Language/Dialect Spoken: Contact Number, if any:

VI.

FAMILY BACKGROUND
Father: Occupation: Mother: Occupation: No. of Brother(s): No. of Sister(s): Contact Number: Address:

VII.

SCHOLASTIC BACKGROUND

High School where Graduate: Year: Address: Honors/Distinction received:

VIII.

Person to be Notified in Case of Emergency:

Name: MR. & MRS. MANUEL L. LERA Address:YUMBING, MAMBAJAO, CAMIGUIN Telephone/Cell No:09058231813

V. Reference ENGR. LEVY F. UBALDE IACC dispatcher Network Operation Division Mindanao System Operation Maria Cristina, Iligan City

___________________________________________ Signature of Student Trainee