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CEBU TECHNOLOGICAL UNIVERSITY

Corner M. J. Cuenco Avenue and R. Palma St.,Cebu City

Republic of the Philippines

COLLEGE OF ENGINEERING ON - THE - JOB TRAINING DEPARTMENT INFORMATION SHEET OF ON-THE-JOB TRAINEE
A. PERSONAL DATA

Surname Course & Major City Address: Telephone No.: Provincial Address: Date of Birth: Civil Status: B. FAMILY DATA Father: Occupation: C. HEALTH DATA Blood Type: Health Problems:

First Name

Middle Name

2x2 photo

Mobile No.: E-mail Address: Place of Birth: Religion:

Mother: Occupation: Weight: Height:

D. SCHOLASTIC DATA Secondary: Address: Year Graduated: Honors / Awards Received: E. WORK EXPERIENCES Position Inclusive Date Company Address Vocational: Address: Year Graduated: Honors / Awards Received:

F. SPECIAL SKILLS AND TALENTS

G. CHARACTER REFERENCES (not related to you) Name Position Address Contact Number

H. IN CASE OF EMERGENCY, PLEASE NOTIFY:

Comm. Tax Cert. No.: Issued At: Issued On:

I HEREBY CERTIFY that the above information is true and correct to the best of my knowledge & belief. Signature of OJT

CEBU TECHNOLOGICAL UNIVERSITY


Corner M. J. Cuenco Avenue and R. Palma St.,Cebu City

Republic of the Philippines

COLLEGE OF ENGINEERING ON - THE - JOB TRAINING DEPARTMENT

PARENTS CONSENT I / We, Mr. and Mrs. ______________________ parents of ____________________________, a prospective On-the-Job Trainee of the Cebu Technological University Main Campus, have hereunto grant permission for him/her to undergo 400 hours On-the-Job Training (OJT) in _______________________________ which is a requirement for graduation. That we made it known our continued financial and moral support to him/her during the training. That we shall adhere to any disciplinary action of the school, such as dropping him/her from the rules of trainees and/or barring him/her from graduation should it be found that he/she is a frequent absentee and/or a notoriously undesirable trainee. WAIVER THIS IS TO CERTIFY that the Cebu Technological University Main Campus and the _________________________ are in no way responsible nor shall pay compensation for any accident, harm or injury that may be caused on our son/daughter during the training, unless all precautionary and preventive measures are being implemented to prevent any accident to happen. It is fully known that we have read and understood all the contents of the parents consent and waiver and have signed the same with our voluntary act and deed. Signed this ______ day of ____________, 2011 in ______________, Philippines. ________________________ ________________________ Signature of Father/Guardian Mother/Guardian WITNESS: Dr. EDGAR U. TIBAY Chair, College of Engineering OJT Program
NOTED: Dr. CORNELIO G. DUASO College Dean CONFORME: ___________________________ Signature of OJT

_Signature of

SUBSCRIBE AND SWORN TO before me this _______ day of _________________, 2011 at ___________________________, Philippines.

CEBU TECHNOLOGICAL UNIVERSITY


Corner M. J. Cuenco Avenue and R. Palma St.,Cebu City

Republic of the Philippines

COLLEGE OF ENGINEERING ON - THE - JOB TRAINING DEPARTMENT


Notary Public

CEBU TECHNOLOGICAL UNIVERSITY


Corner M. J. Cuenco Avenue and R. Palma St.,Cebu City

Republic of the Philippines

COLLEGE OF ENGINEERING ON - THE - JOB TRAINING DEPARTMENT ON - THE - JOB TRAINING AGREEMENT The _____________________________ (cooperating industry) agrees to permit Mr. /Ms. ____________________________ (On-the-Job Trainee) to work in this establishment. In addition, it is agreed that: A. THE ON-THE-JOB TRAINEE AND THE TRAINING PERIOD 1. The On-the-Job Trainee will submit to the cooperating industry the following documents: a. Endorsement letter b. Personal Data Sheet c. Parents Consent and Waiver d. Medical certificate e. Police/NBI clearance (optional) 2. During the training period, Mr. /Ms. __________________________ has a status of a student trainee performing On-the-Job trainee at the cooperating industry. 3. The OJT will conform to all rules and regulations of the cooperating industry. 4. The OJT will perform according to the best of his/her ability all the tasks and activities set by the cooperating industry. 5. The required training period is 400 hours inclusive of regular and overtime working hours. B. THE COOPERATING INDUSTRY 1. The cooperating industry (CI) will assign personnel who will serve as Supervisor to the On-the-Job Trainees. 2. The CI will deploy the On-the-Job Trainees to practical and related works along their area of specialization. 3. On optional basis, the CI will give an allowance during the OJT period. 4. The CI may impose disciplinary action to any OJT with prior notice to the OJT Faculty Chairman for failure to comply with the Companys Rules and Regulations. 5. The CI reserves the right to dismiss the OJT who fails to meet the standards set by the CI after consulting the OJT Faculty Chairman. 6. The CI will evaluate the performance of the OJT and will give a certificate of completion at the end of the training period. The above terms of agreement maybe revised, amended or terminated by the parties involve after a thorough consultation has been made. The parties hereby affix their signatures signifying agreement to the above provisions. CTU System Main Campus _______________________________ Name of Cooperating Industry/Agency Dr. CORNELIO G. DUASO _______________________________ College Dean & Position

Name of Representative

CEBU TECHNOLOGICAL UNIVERSITY


Corner M. J. Cuenco Avenue and R. Palma St.,Cebu City

Republic of the Philippines

COLLEGE OF ENGINEERING ON - THE - JOB TRAINING DEPARTMENT Witnesses: _______________________________ _______________________________ Notary Public

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