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Work Immersion Form 4 (L-Wif4) Accomplishment Report

This document is a work immersion form for a student named Haidee S. Villanueva from the Senior High School Department of San Rafael National Trade School. The form tracks the student's tasks, working hours, and performance over multiple dates during their work immersion placement. It includes spaces for signatures from the student, their work immersion teacher, and supervisor to attest to the reported information and provide additional feedback.

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haezel
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78 views

Work Immersion Form 4 (L-Wif4) Accomplishment Report

This document is a work immersion form for a student named Haidee S. Villanueva from the Senior High School Department of San Rafael National Trade School. The form tracks the student's tasks, working hours, and performance over multiple dates during their work immersion placement. It includes spaces for signatures from the student, their work immersion teacher, and supervisor to attest to the reported information and provide additional feedback.

Uploaded by

haezel
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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L-WIF 4

Republic of the Philippines


Department of Education
Region III- Central Luzon
Schools Division of Bulacan
SAN RAFAEL NATIONAL TRADE SCHOOL
SENIOR HIGH SCHOOL DEPARTMENT
Caingin, San Rafael, Bulacan
Tel. No. 044-816-7789

WORK IMMERSION FORM 4 (L-WIF4)


ACCOMPLISHMENT REPORT
SY ___________

Name of Learner: Haidee S. Villanueva LRN :105115060148 Section: 12-Phoenix Track/Strand/Specialization :Academic /STEM Venue: __________________
(To be accomplished by the
industry supervisor) Signatures
NO. OF STATUS
DATE TASKS WORKING
HOURS REMARKS Work Work
Not
Completed Learner Immersion Immersion
Completed
Supervisor Teacher
L-WIF 4

NO. OF (To be accomplished by the


DATE WORKING STATUS industry supervisor) Signatures
TASKS
HOURS
Work Work
Not
Completed REMARKS Learner Immersion Immersion
Completed
Supervisor Teacher

TOTAL NUMBER OF HOURS

Important: (To be accomplished by work immersion supervisor)

Additional feedback, comment or suggestions regarding the performance/accomplishments of the learners during work immersion.

_____________________________________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________
Prepared:

________________________________________
Learner’s Signature Over Printed Name

Attested:

_______________________________________ ______ ________________________________________


Signature Over Printed Name (Work Immersion Teacher) Signature Over Printed Name (Industry Supervisor)

Noted:

LEODORA G. MENDOZA
Principal III

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