Complete-forms Ojt.docx

Pangasinan State University Urdaneta Campus Urdaneta City, Pangasinan

__________________ __________________ __________________ __________________ Sir/Madam: Greetings! Our University earnestly requests your good office to provide “On-the-Job Training” for the (1ST SEMESTER, 2ND SEMESTER OR SUMMER), Academic Year(2012-2012) to (NAME OF THE STUDENT TRAINEE).He/She is a (YEAR LEVEL) student in (COURSE)under the(DEPARTMENT). The requested training of (minimum number of hours) hours includes exposure to the real industrial environment, observance of safety practices and familiarization with the job/skills related to her field of specialization. Your guidance, assistance and concern extended during her training will be highly appreciated.We hope that this request will be favorably considered in the interest of preparing a pool of competent workers. Thank you very much and God Bless!

Very truly yours, ______________________ OJT - Program Coordinator

Recommending Approval: ENGR. KENNETH LOPEZ Campus OJT Coordinator

DR. ZENAIDA U. SUYAT Campus Executive Director

RECORD FILE

Recent 2x2 picture

NAME:_______________________________________________________________ LAST FIRST MIDDLE COURSE:_____________________________________________________________ CONTACT NUMBER:____________________________________________________ HOME ADDRESS:_______________________________________________________ EMAIL ADDRESS:_______________________________________________________ PARENT/GUARDIAN:____________________________________________________ ADDRESS: ____________________________________________________________ CONTACT NUMBER: ____________________________________________________ OJT COMPANY:________________________________________________________ COMPANY ADDRESS:___________________________________________________ CONTACT NUMBER:____________________________________________________ EMAIL ADDRESS:_______________________________________________________ URL:_________________________________________________________________ SUPERVISOR/HUMAN RESOURCE: _________________________________________ LAST FIRST MI SUPERVISOR CONTACT NUMBER: __________________________________________ COVERAGE DATE OF OJT: FROM_____________________ TO ___________________ (DD/MMM/YY) (DD/MMM/YY)

DOCUMENTS PRE DEPLOYMENT Requirements 1. 2. 3. 4. 5.

Record File Student Trainees’ Personal History Statement OJT Application Form. Latest Resume or Personal Data. Certificate of Grades for the last two semester from the Registrar’s office with campus official seal. 6. Medical clearance 7. Drug Test 8. Good moral character. 9. Guidelines for student trainee. 10. Barangay clearance 11. All pictures in the forms should be recent, colored, 2x2, and in corporate attire. 12. Waiver from parent/guardian. UPON APPROVAL OF COMPANY 1. Memorandum of Agreement (MOA). 2. OJT training agreement . 3. Training Agreement and Liability Waiver for Overtime (OT). 4. Affidavit of Training. POST OJT Requirements 1. Certification from the Department Chairman. 2. Certificate of Training Completion. 3. Student-Trainees Performance Appraisal Report 4. Photocopy of Daily Time Record. 5. Time Frame. 6. Trainee’s Weekly Report. 7. OJT Narrative Report. 8. OJT Training Supervisor’s Feedback Form. 9. Student-Trainees’ Feedback Form.

Complied

OJT Form Student-Trainees Personal History Statement Republic of the Philippines PANGASINAN STATE UNIVERSITY URDANETA CITY, Pangasinan Recent 2x2 picture STUDENT TRAINEES’ PERSONAL HISTORY STATEMENT

Student Information LAST NAME: AGE:

FIRST NAME:

HEIGHT:

WEIGHT:

SEX

MIDDLE NAME: MALE

FEMALE

COMPLEXION:

DISABILITY(IF ANY)

Tel No.:

BIRTHDATE:

BIRTHPLACE: (mmddyy)

CITIZENSHIP: PRESENT ADDRESS:

CIVIL STATUS: TEL NO.

PROVINCIAL ADDRESS

TEL NO.

Family Background(if parents are deceased give data for the nearest relative and indicate relationship to applicant) FATHER’S NAME: MOTHER’S NAME:

OCCUPATION: OCCUPATION:

ADDRESS OF PARENTS:

TEL NO:

GUARDIANS NAME: SCHOOL INFORMATION

TEL NO:

COURSE:

YEAR LEVEL:

MAJOR:

LENGTH OF COURSE:

DEPARTMENT:

SCHOOL ADDRESS:

OJT Program COORDINATOR:

TEL NO:

OJT Campus COORDINATOR: MR. LOPEZ, Kenneth CAMPUS EXECUTIVE DIRECTOR

TEL NO: 0755682040 TEL NO:

DR. ZENAIDA U. SUYAT

0755682040

In case of emergency, notify NAME: ADDRESS:

RELATIONSHIP: TEL NO:

I hereby certify that the foregoing answers are true and correct to the best to my knowledge, belief and ability, Signed at:____________________________ Date:____________________________ ____________________________________ Applicant’s Signature over Printed Name

OJT-APPLICATION FORM DR. ZENAIDA U. SUYAT Campus Executive Director Pangasinan State University Urdaneta Campus Urdaneta City, Pangasinan May I have the honor to apply for placement in the Supervised On The Job Training Program for the period of _____________ training hours. The following are m particulars and preference for our favorable consideration. PERSONAL DATA: Name: __________________________________ Age: _______ Contact no: ________________ Sex: _______________ Civil Status: _____________________ Religion: __________________ Home Address: ________________________________________________________________ ACADEMIC DATA: Course: _______________________________________ Year & Section: _________________________________ PREFERENCE FOR PLACEMENT: 1st Company: ______________________________________________________________ Address: __________________________________________________________________ Contact Person: ____________________________________________________________ Position: _______________________________________ Contact Number: ________________________________ (if any) 2nd Company: ______________________________________________________________ Address: __________________________________________________________________ Contact Person: ____________________________________________________________ Position: _______________________________________ Contact Number: ________________________________ (if any)

Very truly yours,

_________________________________ (Signature of Student over Printed Name) CTC No.: ____________________________ Issued on: __________________________ Issued at: __________________________ RECOMMENDING APPROVAL: _______________________________ Department Chairman

APPROVED: DR. ZENAIDA U. SUYAT Campus Executive Director

PERSONAL DATA

2X2 PHOTO

NAME: ___________________________________________________ ADDRESS: ________________________________________________ TELEPHONE NO.: ______________________CP#: _________________ Email Address:________________________ URL:_________________ CAREER OBJECTIVE: _____________________________________________________________ _____________________________________________________________ WORK EXPERIENCE: Inclusive date Employer Position & Job Description

TRAININGS & SEMINARS ATTENDED: Title of Seminar

EDUCATIONAL BACKGROUND: Level Elementary High School College

Inclusive Date

School

Inclusive Date

EXTRA CURRICULAR ACTIVITIES

PERSONAL BACKGROUND: Nick name Age Gender Weight Height Civil Status Religion REFERENCES: Name: Position: Employer: Tel No.:

Name: Position: Employer: Tel No.:

Name: Position: Employer: Tel No.: _________________________ Student Signature/Date

GUIDELINES FOR THE STUDENT TRAINEE Dear Student Trainee: You are ready to go to your respective training station. While you are undergoing the On the Job training, please observe these guidelines which are intended for your protection and worthwhile stay in the training agency/company. 1. You are required to pass or attend the following activities; a. Pre and Post Practicum Seminar b. Department Interview c. Industry partner interview/screening & orientation (as needed) d. Other activities as required by the OJT supervisor 2. Follow the rules and regulation of the agency/company regarding the training program. 3. Maintain the good image of the College while undergoing training. Through your performance and courteous attitude towards the personnel of the agency/company. 4. Promote a good and promote wholesome relationship between the COLLEGE and the training station. 5. Stick to your assignment and never leave the agency/company without the knowledge and sanction of the COLLEGE. 6. Communicate with the COLLEGE on matters pertaining to problem you encounter while on training for proper solution and/or factual information related to your problem. 7. Accomplish OJT Form regarding your day to day accomplishment and compile them chronologically in a folder. 8. At the end of the training program request from the agency/company your CERTIFICATE OF COMPLETION OF TRAINING together with Performance Evaluation Report from your training personnel. 9. Immediately after the training, submit to the OJT Coordinator the following requirements: a. OJT Logbook or Journal for Daily Work Act b. OJT Evaluation Report c. Certificate of Training Completion d. Narrative Report ( Two (2) weeks after the training ) e. Others as maybe required by the OJT Coordinator 10. Your final grade maybe based on the following criteria.

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CRITERIA OJT Narrative Report Student Trainee Journal Attendance & Participation In pre &post Seminars and other activities Performance Evaluation Report ( from Cooperating Agency ) Field Observation by the Coordinator Total

GOODLUCK AND ENJOY YOUR TRAINING!

DR. ZENAIDA U. SUYAT Executive Campus Director

CONFORME: __________________________________________ Signature of Trainee over Printed Name

PERCENTAGE 35% 20% 35% 10% 100%

WAIVER I _________________________, of legal age, a Filipino citizen and residing at ______________________________________________ and has applied for On the Job Training with the company/agency that I prefer for a period of ________ hours this Summer 20___,as a student of PANGASINAN STATE UNIVERSITY, URDANETA CAMPUS, Urdaneta City, Pangasinan and in consideration therefore, hereby freely and voluntarily assume myself the following terms and conditions, viz: 1. That I recognize the authority of my cooperating agency where I will be having my OJT and submit myself to all the rules and regulations that are upon me in connection with my training; 2. That I renounce and waive any claim(s) against the cooperating agency/company and the PSU, URDANETA CAMPUS, URDANETA CITY, PANGASINAN for any injury and/or accident or loss that I may suffer, personal or pecuniary, in the performance of my duties or functions while undergoing training, provided that the cooperating agency ensures my safety and welfare while in their care and therefore shall not assign me to jobs that might danger my safety, health and welfare; and 3. Finally, I am aware that I am not entitled to any kind of compensation and/or remuneration from the agency/company unless traveling allowance and/or other expenses will be given to me voluntarily by the cooperating agency/company concerned. Signed this _____________day of _______________, 20 __ in Urdaneta City, Province of Pangasinan, Philippines. ______________________________________ (Signature over Printed Name) CTC No.: ____________________ Issued at: ___________________ Issued on: ___________________ PARENTS’/GUARDIANS CONSENT I fully agree with all the terms and conditions provided for in this WAIVER executed this ____ day of ______________ 20___, hence, I hereby give my full consent for my son/daughter ________________________ to undergo the On The Job training inhis/her preferred company/agency for the specified training period of ________ hours this Summer of 20_____. _____________________________________ (Signature of parent/Guardian) Res Cert #: ___________________ Issued at ____________________ Issued on ____________________

Signed in the Presence of: _________________________

_____________________________

ACKNOWLEDGEMENT SUBSCRIBED AND SWORN to me before me this _____ day of _____________, 20__ in ____________________, Pangasinan. Doc No. ______ Page No. _____ Book No. _____ Series of _____

MEMORANDUM OF AGREEMENT

KNOW ALL MEN BY THESE PRESENTS: This Memorandum of Agreement is made and entered into by and between: The PANGASINAN STATE UNIVERSITY – URDANETA CAMPUS (PSUURDANETA), with principal address at McArthur Hiway, Brgy. San VicenteUrdaneta City, Pangasinan, represented herein by its Campus Executive Director, in the person ofDR.ZENAIDA U. SUYAT, herein after referred to as “FIRST PARTY”. -AndThe ______________________________________________________, with principal address at__________________________________________________________represented by its ______________________________, in the person of ________________________________ of legal age, Filipino, with the same address of the above firm, now and hereinafter referred as “SECOND PARTY”. WITNESSETH: THAT WHEREAS, FIRST PARTY, is offering courses which require On-The-Job Training of its students, in compliance to the requirements of the Commission on Higher Education; WHEREAS, SECOND PARTY, is willing to take-in qualified students for On- The – Job Training; WHEREAS, both parties, in order to achieve the above-mentioned purpose, bind themselves to the following modes of cooperation: Student training and Education; NOW THEREFORE, for and in consideration of the foregoing premises, the parties hereto bind themselves to this AGREEMENT, subject to the following terms and conditions to wit; 1.0 FIRST PARTY shall: 1.1 Endorsed qualified students who will undergo training at SECOND PARTY. 1.2 Monitor progress of students’ OJT through the assigned OJT Coordinator; 1.3 Assist in promotion of Company’s Programs ; 1.4 Provide SECOND PARTY with rating sheets for the students’ performance evaluation and for these rating sheets to be submitted by the students to FIRST PARTY after the completion of their training; and 1.5 Will have a waiver signed by the students and parents to renounce and waive any claim(s) against the FIRST PARTY and the SECOND PARTY for any injury and/or accident or loss that the student may suffer, personal or pecuniary, in the performance of the students duties or functions while undergoing training, provided that the cooperating agency ensures the students safety and welfare while in their care and therefore shall not assign the student to jobs that might danger its safety, health and welfare;

2.0 SECOND PARTY shall: 2.1 Orient the student-trainee on safety before deployment; 2.2 Provide ID as temporary pass to enter the company; 2.3 Allow students to undergo OJT in its offices for a minimum of 200 hrs and maximum of 500hrs on the following condition: 2.3.1. That there will be no employer- employee relationship between the Company and the School and between the company and the students. 2.3.2 That FIRST PARTY shall designate a coordinator who will coordinate the Company’s various activities under this program. 2.3.3. The participation in the training program does not imply any future employment rights to the FIRST PARTY’s student. The SECOND PARTY neither represents nor implies any obligation to the student upon completion of the Immersion Program. 2.3.4. This agreement maybe terminated for convenience by the SECOND PARTYupon its prior written notice within reasonable time to the FIRST PARTY or Program Coordinator. This paragraph shall notdeemed to waive, prejudice or diminish any right, which the SECOND PARTY may have in law or equity for any unlawful termination or other breach of this Agreement, by the FIRST PARTY. 2.3.5. Each student shall submit to the SECOND PARTY detailed reports and documentation with respect tothe services performs by her as may be periodically required by the SECOND PARTY. The report shall disclose an update of all work or service completed, including result and ideas, with developmentand inventions derived and conceived to the practiced during the course of the student’sdocumentation such as graphs, computer program, formula, sketch, drawing summaries and the like; 2.3.6. That the student-trainee shall adhere to all the Station’s Safety Rules and Regulations. Any safety violation committed by a student –trainee would mean Termination of his/her OJT contract 3. That neither party shall publicly announce the existence of its Agreement, or advertise or release hereof, before during and after the existence of this Agreement without securing the prior written consent of the other. 4. Under the Memorandum of Agreement, the following terms and conditions are likewise included; a. Any changes, modifications and alterations on any of the foregoing provisions of this contract shall be made only upon the mutual consultation and agreement of both parties; b. This agreement shall be for a period of one (1) calendar years from date of signing without prejudice for further extension upon mutual agreement.

5. Special Consideration Neither party shall be considered liable nor shall no damage on either side be incurred in case this Agreement will be discontinued on account of force majeure, or as a result of a government policy. IN WITNESS WHEREOF, the parties hereto have signed these presents on this on ____ day of ____________, 20___ at ________________________________________. “ FIRST PARTY”

“ SECOND PARTY”

DR. ZENAIDA U. SUYAT Campus Executive Director

___________________________

Signed in the Presence of:

_________________________ ENGR. KENNETH LOPEZ OJT Campus Coordinator

___________________________

ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES ) PROVINCE OF ______________________ ) CITY OF ____________________________) BEFORE ME, Notary Public for and in the Province of _____________, appeared the above-named parties including their instrumental witnesses, known to me be the same parties who executed the foregoing AGREEMENT, and who acknowledged to me that the same is their own free act and deed. This instrument consists of three pages and the parties their witnesses have signed their names on both pages thereof. WITNESS MY HAND AND SEAL at the place first given above, this ___ day of _______________.

Doc No........... Page No......... Book No........ Series of ……

ON-THE -JOB TRAINING AGREEMENT KNOW ALL MEN BY THIS PRESENTS: This On the Job training agreement is entered into by the PANGASINAN STATE UNIVERSITY, Urdaneta Campus, Urdaneta City, Pangasinan represented herein by DR. ZENAIDA U. SUYAT in his capacity as the Executive Campus Director, hereinafter referred to as the UNIVERSITY; ____________________________________ a student of PSU-Urdaneta, Urdaneta City, Pangasinan taking up ______________________________________________ major in ___________________________ and resident of __________________________________________ herein after referred to as TRAINEE; and ____________________________________________________ a duly organized and existing business company/corporation with address at _____________________________________________ represented herein by _________________________________________ in his capacity as ___________________________ referred to as COMPANY/ CORPORATION.

WITNESSTH That the PARTIES CONCERNED hereby entered into this on the job training agreement under the following terms and conditions; 1. 2. 3. 4. 5.

6.

That the UNIVERSITY hereby certifies that the Trainee is its bonafide student and that the same TRAINEE has completed all requirements prerequisite to his /her on the job training activities; That the TRAINEE will undergo on the job training in the COMPANY/CORPORATION for no less than __________ training hours; That the TRAINEE must follow the COMPANY/CORPORATION rules and regulations during the period of his/her training; That the TRAINEE will not be entitled to any compensation from the COMPANY/CORPORATION unless the COMPANY/CORPORATION will allow; The COMPANY/CORPORATION and the UNIVERISITY will not be responsible to whatever injury and/or accident that the TRAINEE might sustain in the course of his/her training provided that the cooperating agency ensures the students safety and welfare while in their care and therefore shall not assign the student to jobs that might danger its safety, health and welfare; That the COMPANY/CORPORATION shall supervise the conduct of Training on the TRAINEE and shall give the necessary rating for the TRAINEE’S accomplishments upon the completion of his/her training. IN WITNESS WHEREOF, the PARTIES hereunto affixed their signatures this ______ th day of ________________________, 20__ in _____________________________________. ________________________________ Company/Corporation Representative Res. Cert. No._____________________ Issued at ________________________ Issued on________________________

__________________________________ Signature of Trainee Res. Cert. No.________________________ Issued at ____________________________ Issued on ___________________________

PANGASINAN STATE UNIVERSITY Urdaneta Campus Urdaneta City, Pangasinan _________________________________ DR. ZENAIDA U. SUYAT Executive Campus Director Res Cert. No. _____________________ Issued at ________________________ Issued on ________________________

________________________________ MR. LOPEZ, KENNETH OJT Campus Coordinator Res. Cert. No. _______________________ Issued at ___________________________ Issued on __________________________

Executed and Signed before me this ________ day of ___________, 20__, in _______________, Pangasinan. Doc.____________ Book.___________ Page No. ________

__________________________ Notary Public

TRAINING AGREEMENT AND LIABILITY WAIVER FOR OVER TIME (OT) I, ______________________________ a student of Pangasinan State University, hereby voluntarily agree to undergo overtime training in my Internship Training at ___________________________ under the following terms and conditions: a. that I have consent from my parents/guardians for the said overtime. b. that the company/establishment where I am undergoing my training has the knowledge of the overtime. c. that I fully understand that the Pangasinan State University and ______________________ is no longer responsible/liable for any injury or incident that may occur during the said overtime.

Student’s Signature over Printed Name Res. Cert. No.________________ Issued on ; __________________ Issued at: ___________________

With Our Consent and Approval: Parent’s/Guardian’s Signature Res. Cert. No.: __________________ Issued on: ______________________ Issued at: ______________________

Company Representative’s Signature Res. Cert. No.________________ Issued on: ___________________ Issued at: ____________________

Signed in the presence of: OJT-Campus Coordinator Res. Cert. No.: __________________ Issued on: ______________________ Issued at: ______________________

SUBSCRIBE AND SWORN TO BEFORE ME this _____ day of _________ 20___ at ___________________, Philippines.

REPUBLIC OF THE PHILLIPPINES _________________________ ___________________________________________________ _______________________________________

AFFIDAVIT OF TRAINING I _____________________________, of legal age, Filipino, single, and a resident of _______________________________________________after having been duly sworn to in accordance with law, under oath depose and say; 1. That I am a_____________________________________ student of Pangasinan State University Urdaneta Campus, Urdaneta City; 2. That I am a _____ year in the same institution and already eligible for an on job training as required in our curriculum; 3. That I am undergoing on the on job training with _____________________________ at _______________________________________; 4. That I agree that in the course of my job training, Pangasinan State University and the Company I’m having my OJT are not responsible/liable/or whatsoever for any injury or damages that I may suffer; 5. That I am executing this affidavit to attest to the facts narrated. IN WITNESS WHEREOF, I have hereunto set my hand this ____ _________________________ 20__ at ________________________________.

day

of

__________________________ Affiant Signed in the presence of:

________________________________ Company/Corporation Representative

MR. LOPEZ, KENNETH

OJT Campus Coordinator

Executed and Signed before me this ________ day of ___________, 20__, in _______________, Pangasinan. Doc.____________ Book.___________ Page No. ________

__________________________ Notary Public

Pangasinan State University Urdaneta Campus Urdaneta City, Pangasinan

____________________ DEPARTMENT

CERTIFICATION This is to certify that _________________________________ a ____________________________student has been fully evaluated and satisfied the_______hours of his/her OJT training, met the specific objectives set by our department for its respective Program,and complied with the Guidelines for Student Internship Program in the Philippines (SIPP) for all Programs with Practicum Subject. Certified this ______ day of _____________ 20______.

________________________________ _____ Department Chairman

OJT FORM STUDENT-TRAINEES PERPORMANCE APPLICATION FORM Republic of the Philippines PANGASINAN STATE UNIVERSITY Urdaneta City, Pangasinan

STUDENT-TRAINEES PERFORMANCE APPRAISAL REPORT ____________________________________ ________________________________ Student Trainees/Course/Year Level Name of Company ____________________________________ ________________________________ Semester/No. of Training Hours Address of Company Part I-DIRECTION: Please rate by checking the appropriate column that best describes the performance of the above student trainee. Please use the ratings as follows: Five (5) being the highest and one (1) the lowest. CRITERIA ATTENDANCE & PUNCTUALITY 1. Reports on time 2. Reports regularly 3. Requests permission before being absent PERFORMANCE 1. Knows his/her work well 2. Completes assignment on time 3. Works with speed and accuracy 4. Ensures Quality of work 5. Produces much output with less time 6. Displays resourcefulness 7. Requires less supervision 8. Has initiative GENERAL ATTITUDE 1. Shows interest in his/her work 2. Accepts suggestions 3. Cooperates well with everybody 4. Exhibits honesty and dependability 5. Follows instruction 6. Observes safety rules and regulations 7. Accepts responsibility 8. Respects superiors 9. Shows friendliness and pleasant attitude

1

2

3

4

5

TOTAL POINTS: _________ COMMENT/SUGGESTIONS:_________________________________________________________________________________ ________________________________________________________________________________________________________ _________________________ Rated by: __________________________ Training Supervisor Part II-To be accomplished by the IACEPO Coordinator: Name of student –trainee:_________________________________________ Course/Year:__________________________ Name of Company:____________________________________Semester:___________S.Y.__________________________ Part I-In-Plant Performance Appraisal__________________________________________60% =___________________ Performance Appraisal and other requirements ________________________________ 40% =___________________ Total: 100% Final Grade:_________ Rating Scale: Numerical Grade Equivalent Adjectival Grade Numerical Grade Equivalent Adjectival Grade 1.00 98-100 Excellent 2.75 78-79 Fairly Satisfactory 1.25 94-97 Superior 3.00 75-77 Passing 1.50 90-93 Very Good 4.00 70-74 Conditional Failure 1.75 88-89 Meritorious 5.00 below 70 Failure 2.00 85-87 Very Satisfactory Inc Incomplete 2.50 80-82 Satisfactory Drp Dropped Rater: ______________________________

OJT Coordinator

ON-THE-JOB TRAINING TIME FRAME Name of Student-Trainee:____________________________ Year/Course:_____________________ Name of Company and Address : ________________________________________________________ Required Number of Hours : _________________ Date

Day

Total Number of Hours Prepared by: _______________________ Signature over Printed Name of Student – Trainee Approved: ___________________________ Signature over Printed Name of Company’s Authorized Representative Noted: ___________________________ Signature over Printed Name of OJT Coordinator

Number of Hours

Related Learning Experience (RLE) Journal TRAINEE’S WEEKLY REPORT (Week _______) ___________________________ Period Covered

__________________________ Department/Section Training Activity

No. of Hours

Day: Date: Day: Date: Day: Date: Day: Date: Day: Date: Day: Date: Prepared by:_______________________ Student-Trainee

Attested by: _______________________ Training Supervisor (Signature over Printed Name)

Noted by: ____________________ OJT Program Coordinator (Signature over Printed Name)

MR. LOPEZ, KENNETH OJT Campus Coordinator (Signature over Printed Name)

Format of Narrative Report

My On –the – Job Training Experience

Format:  legal size Paper  Double spacing  Minimum of 500 words  Font/Size: Times New Roman/12  Margins: top/right /bottom = 1” Left = 1.25”  Include pictures with caption minimum of 10 pictures. Maximum of two pictures page.

Prepared by: Student Name Course

Noted: ______________________ OJT Program Coordinator ______________________ Department Chairman

MR. LOPEZ, KENNETH OJT Campus Coordinator

OJT FORM TRAINING SUPERVISORS FEEDBACK FORM Republic of the Philippines

PANGASINAN STATE UNIVERSITY Urdaneta City, Pangasinan

Name of the Training Supervisor: _____________________________ Name of the Company: _____________________________________ Date of Monitoring: ________________________________________ Name of Student – Trainee: _________________________________

Department: __________

TRAINING SUPERVISOR’S FEEDBACK FORM The student-trainee: 1. is punctual in attending work and assignments. Strongly Agree

Agree

Neither agree or disagree

Disagree

Strongly disagree

2. has sufficient knowledge to contribute in the organization. Strongly Agree

Agree

Neither agree or disagree

Disagree

Strongly disagree

Disagree

Strongly disagree

3. knows how to work with the group. Strongly Agree

Agree

Neither agree or disagree

4. performs tasks as prescribed In the Internship Training Plan. Strongly Agree

Agree

Neither agree or disagree

Disagree

Strongly disagree

Disagree

Strongly disagree

Disagree

Strongly disagree

Disagree

Strongly disagree

5. follows and abides with the policies of the company. Strongly Agree

Agree

Neither agree or disagree

6. maintains an upright conduct while in the company. Strongly Agree

Agree

Neither agree or disagree

7. shows desirable traits, virtues and work habits. Strongly Agree

Agree

Neither agree or disagree

Other Comments and Suggestions: _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

__________________________ Training Supervisor’s Signature

OJT FORM STUDENT-TRAINEES FEEDBACK FORM

Republic of the Philippines

PANGASINAN STATE UNIVERSITY Urdaneta City, Pangasinan

STUDENT-TRAINEES’ FEEDBACK FORM Name of Student-Trainee: ____________________________________ Course: __________________ Name of Company: ___________________________________ Department: __________________ Date of Monitoring: __________________________________

1. My training is aligned with my field of specialization. Strongly Agree

Agree

Neither agree or disagree

Disagree

Strongly disagree

Neither agree or disagree

Disagree

Strongly disagree

Disagree

Strongly disagree

Disagree

Strongly disagree

2. My training is challenging. Strongly Agree

Agree

3. I have opportunities for learning. Strongly Agree

Agree

Neither agree or disagree

4. I am aware with the policies of the company. Strongly Agree

Agree

Neither agree or disagree

5. I have positive working relationship with my supervisor and other employees of the company. Strongly Agree

Agree

Neither agree or disagree

Disagree

Strongly disagree

6. I am aware of the risks and hazards of my working environment. Strongly Agree

Agree

Neither agree or disagree

Disagree

Strongly disagree

7. My department is committed to ensuring the health and safety of its student-trainees. Strongly Agree

Agree

Neither agree or disagree

Disagree

Strongly disagree

Problems Met: ________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Other Concerns: _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

_________________________ Student – Trainee’s Signature