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Ojt Forms

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Republic of the Philippines BULACAN STATE UNIVERSITY City of Malolos, Bulacan

College of Engineering

On-The-Job Training Program

Performance Evaluation Report

Student Trainee __________________________________ Age _______ Sex ________
Course ________________________________ Major __________________________

Name of Firm _________________________ Address____________________________

No. of Training Hrs. Required ___________Total Hrs. Rendered ___________________
Job Assigned ____________________________________________________________
Training Period: From ______________________to _____________________________ ________________________ Signature
|CRITERIA |Max. rating |RATING |
| |to be given | |
|1. Quality of work (thoroughness, accuracy , neatness and effectiveness) |20% | |
|2. Quantity of work (able to complete work in allotted time) |20% | |
|Dependability, reliability, and resourcefulness |10% | |
|(ability to work with min. amount of Supervision) | | |
|. Judgement (sound decisions, ability to identify and evaluate pertinent factors) |10% | |
|5. Cooperation (works well with everyone, good team work) |10% | |
|6. Attendance (regularity and punctuality in office attendance and proper observation |10% | |
|of break period) | | |
|7. Personality (personal grooming and pleasant disposition) |10% | |
|8. Safety (awareness of safety practices) |10% | |

TOTAL RATING ______________
Recommendation for the trainer’s future growth:
________________________________________________________________________
_______________________________________________________________________.

Evaluated by: Noted by:
_________________________ ________________________ Name and Signature Name and Signature
_________________________ ________________________ Designation Designation
Republic of the Philippines
Department of Labor
BUREAU OF LABOR STANDARDS
Manila

APPLICATION FOR A SPECIAL CERTIFICATE FOR THE TRAINING OF LEARNER OR APPRENTICE WITHOUT COMPENSATION AS A REQUIREMENT OF A SCHOOL CURRICULUM OR AS A PREREQUISITE FOR A BOARD EXAMINATION.

This is an application only. It is not a permit for the training of apprentice or a learner without compensation.

NOTE: This application must be accomplished by a certification from the school attended by the apprentice or learner stating the number of hours of on-the-job training required by the curriculum or the title on degree completed, cited the major subject. Attached recent photo of apprentice or learner. Application not fully accomplished shall not be entertained.

1. Name of establishment: _________________________________________________________
2 Address of Location: ___________________________________________________________
3 Name of Proposed Apprentice / Learner: ___________________________________________
4. Period of training undergone by proposed apprentice or learner in other companies, if known: ___________________________________________________________________________
5. Purpose of training: ___________________________________________________________________________ (State whether as a requirement of a school curriculum or as a pre-requisite for a board exam)
6. Nature of training: _____________________________________________________________
7. No. of hours, days, weeks, months, or years of training requested: ______________________ ____________________________________________________________________________
8. No. of hours of training to be spent daily: ___________________________________________

The undersigned certifies that the information given is true and correct and that the training of the above-mentioned apprentice or learner will not prejudice the existing office personnel of the establishment and that the picture attached is that of the apprentice or learner. Immediate training of said apprentice / learner is hereby assured by the undersigned upon issuance of the certificate.

_ __ __________ ________________________ (Signature of the Employer) 1 x 1 Picture ________________________ ___ __________ (Designation) ________________________ (Date)

(Signature of Apprentice / Learner) (Taxpayer Identification Number)
______________________________________________________________________________
(Address) (Date, Start of Training)

This is to certify that ________________________________ is enrolled at the Bulacan State University, Malolos, Bulacan, summer _____________in the Engineering Course with major in _______________________. This industrial training for ____________and maximum of __________ hours is a requirement for the course.

_______________________ ________________________ Industrial Coordinator Registrar
Republic of the Philippines
BULACAN STATE UNIVERSITY
City of Malolos, Bulacan

W A I V E R

I,______________________ of legal age, single/married, and residing at ______________________ through the request of the Bulacan State University and _____________________ (Firm) and in consideration thereof, hereby freely and voluntarily assume and impose upon myself the following duties; That I recognize the authority of the ________________under whom I am placed and submit myself to rules and regulations that maybe imposed in connection with my training; That I assume full responsibility to all damages incurred by me arising out of and in course of my training during off hours; Furthermore, I renounce and waive any all claims against the Bulacan State University and __________________ (Firm) for any injury that may sustain or any loss that I may suffer, personal or pecuniary, in the performance of my duties or functions. Signed at Malolos, Bulacan this ______ day of _____ 20 ______. ___________________ Signature
WITNESS:
___________________
___________________

C O N F I R M A T I O N That we ___________________________ of legal age, Filipino and a resident of ________________________ after being duly sworn in accordance with law hereby agree and state: That we hereby confirm the above waiver appearing in this instrument. ______________________________ SIGNATURE OF PARENTS/GUARDIAN

Subscribe and sworn to before me this _____________ day of __________2005 affiant exhibiting his/her residence certificate No._______________ issued at ___________ on _____________.

______________________ (Administering Officer)

BULACAN STATE UNIVERSITY
Malolos, Bulacan

College of Engineering

Student Information Sheet

PERSONAL DATA:

Name: __________________________________________________________________ Status: ____________________Course: ____________________ Year: ____________ Nationality: _______________
Major: ____________________________Length of Course in Years: _______________
City Address: _________________________Tel no./Mobile no. ___________________
Pro. Address: _________________________ Tel no. /Mobile no. __________________
Date of Birth: _________________________ Place of Birth _______________________
Age: _______ Sex: ________ Height: ________ Weight: ________ TIN _____________
Physical Disability, if any: _________________________________________________

FAMILY BACKGROUND:

Father’s Name: ________________________________ Occupation: _______________
Mother’s Name: _______________________________ Occupation: ________________
Address of Parents: _________________________ Tel no. /Mobile no. ______________

SCHOOL DATA:

Name of School __________________________________________________________
Training Coordinator: ______________________Tel no. /Mobile no. _______________
School Address: __________________________________________________________
Head of School: ___________________________ Tel no. /Mobile no. _______________

IN CASE OF EMERGENCY, NOTIFY:

Name: ______________________________________ Relationship: ________________
Address: ____________________________________________ Tel no. _____________

I HEREBY CERTIFY THAT THE ANSWER GIVEN ABOVE ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF.

: : : : _______________________
: 1X1 : : 1x1 : Signature of Student
: photo : : photo :
: : : : _______________________ Print Name of Student

Date Accomplished: _______________________________________________

Republic of the Philippines
BULACAN STATE UNIVERSITY

Malolos, Bulacan

COLLEGE OF ENGINEERING

__________________________

Date

___________________________________

___________________________________

___________________________________

SIR / MADAM:

In pursuance with the university objectives to upgrade the skills and competencies of its ______________________________________________ students, the undersigned request your good office that this student be accommodated for on-the-job training in your establishment.

As a major requirement of the course, he/she is to undergo training for _____ hours during the Summer of the School Year ____________. All pertinent records shall be submitted to your office at the commencement of their training.

The undersigned wishes to take this opportunity to extend their sincere appreciation for your kind support on the On-the-job Training Program of the university.

Very truly yours,

OJT Coordinator

DR. NICANOR C. DELA RAMA

Dean, College of Engineering

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