Appendix A.

(Form 1)

ON-THE-JOB TRAINING AND INTERNSHIP ORIENTATION GUIDE

Term Second, SY 2024 - 2025

A. Training Details

Period of : January 30, 2025 – April 21, 2025

Training
Inclusive : Fro February t Apri
Dates m 4, 2025 o l 21,
202
5
Minimum
Hours : 360 Training Hours
Requirement
Orientation : January 30-February 3, 2024
Schedule
Issuance of :
Orientation After due consultation with the faculty coordinator
Clearance

OJT
Requirement
s
1. Before :
a) Accomplished OJT Forms (Forms 2, 3, 4, 5, and 6)
Training
b) 2 pcs. 1 ½ x 1 ½ ID pictures
c) Orientation Clearance (Form 1)
d) Other documents required by the host company

2. During :
a) Accomplished Weekly Log Sheets (Form 7)
Training
b) Authenticated Daily Time Record (DTR) from the host
company

3. After : a) Accomplished Training Performance Evaluation Form

Training (Form 8)
b) Training Executive Summary (Form 9)
c) OJT Training and Apprenticeship Program Evaluation
Form (Form 10)
d) Photocopy of Certificate of Completion

Submission of : Februar
Up to 2025
Requirements y 4,
Issuance of :
Orientation After undergoing pre-deployment orientation activities.
Clearance

B. Forms
1
 Host Faculty
Distrib Stud
Forms to be Comp Coordin
ution ent’s
accomplished any’s ator’s
copies copy
copy copy
F
Orientatio
o
n Guide
r 2 1 1
and
m
Clearance
1
F
o
Student’s
r 2 1 1
Intent
m
2
F
Certificatio
o
n from the
r 2 1 1
Departmen
m
t
3
F
o Trainee
r Informatio 2 1 1
m n Sheet
4
F
o Practicum
r Schedule 3 1 1 1
m of Works
5
F
o
Waiver of
r 3 1 1 1
Liability
m
6
F
o Training
r Recommen 2 1 1
m dation
7
F
o Accomplish
r ed Weekly 5 5
m Log Sheets
8
F Accomplish
o ed Training
r Performan 1 1
m ce
9 Evaluation

2
 Form
F
o
Executive
r
Summary 1 1
m
Report
1
0
F Training
o and
r Internship
1 1
m Program
1 Evaluation
1 Form

C. Evaluation

1. Student Teaching Evaluation Tool

2. Daily Reflection Journal
3. DTR
4. Teaching Internship Workbook and Portfolio
5. Final Demonstration
6. Clearance (Post-deployment)
7. Forms 9, 10 & 11

D. Grading System

Students who have accomplished the minimum requirement set for the NBSC
undergraduate OJT, Practicum, and Internship Program, i.e., 360 training hours, shall mark
its equivalent letter grade in the Official Grading Sheets; otherwise, “F” for Failed or “INC”
for Incomplete. INC mark shall be given only to students who have, in any extraordinary
circumstances, not be able to comply with all the training requirements. But this shall strictly
follow the NBSC policy on “Incomplete Marks” (Ref.: Student Manual, 2020 Edition). The
college procedure for the completion of requirements and the changing of marks applies.

I, _____________________________________, a 4th-year student of the Institute for Teacher

Education, (course) _________________________________, have understood fully well all the
above pertinent details and conditions set for my On-The-Job Training (OJT), Practicum and
Internship Apprenticeship Program during the Second semester of SY 2024 - 2025 and that I shall
accomplish and submit on time all the training requirements that are demanded of me as a student-
trainee.

_______________________________
Student-Trainee’s Signature

_______________________________
Date
Attested:

3
___________________________________________
Signature Over Printed Name of Faculty Coordinator

No. __________

OJT ORIENTATION CLEARANCE

___________, 20 ____

Name:
________________________________________________________
Date: ____________________ Time:
____________________
Venue:
_______________________________________________________

Issued by: _______________________________________________

Signature over printed name

4
Appendix B. (Form 2)

January 30, 2025

Christine C. Royo, PhD

Program Head
Northern Bukidnon State College
Kihare, Tankulan, Manolo Fortich, Bukidnon

Dear Dr. Royo,

This is to signify my willingness and readiness to attend and participate in the NBSC Institute for
Teacher Education On-the-Job Training and Internship Program this 2nd semester of 2024-2025, one
of the requirements of which is my participation in the OJT Orientation, and to abide by the terms
and conditions holding a minimum of 360 hours from February 4 to April 21, 2025, at
____________________________________, free from any liability for negligence or willful acts on
my part. Furthermore, I shall observe all school/company rules and regulations. I shall complete the
minimum number of training hours prescribed for my assigned tasks during the training
conscientiously, diligently, and to the best of my abilities.

I understand that this undertaking is an integral part of the course curriculum and a pre-requisite for
graduation in the Institute for Teacher Education of Northern Bukidnon State College.

Very truly yours,

___________________________________
Signature over printed Name of Student Intern

Course & Year ________________

5
Appendix C. (Form 3)

CERTIFICATION

This is to certify that __________________________________ is a 4th-year Institute for Teacher

Education student (course) _______________________________ of Northern Bukidnon State
College. The trainee is qualified to undergo a 360-Hour Training in your school/company for the
Term Second Semester of AY 2024- 2025.

This certification is issued to enable the above-mentioned student to undertake the minimum
training hours as a course requirement and pre-requisite for graduation.

Issued this 30th day of January, 2025, at the Institute for Teacher Education, Northern Bukidnon State
College.

CHRISTINE C. ROYO, PhD

Department Chair

6
Appendix D. (Form 4)

TRAINEE INFORMATION SHEET

PHOTO
2 x 2 ID

PERSONAL DATA:
NAME SEX AGE
PLACE OF
DATE OF BIRTH
BIRTH
NAME OF SPOUSE, if
CIVIL STATUS
married
CITIZENSHIP RELIGION
CITY ADDRESS
FATHER MOTHER
HOME/MAILING ADDRESS
TELEPHONE/FAX
NUMBER(S)

EDUCATIONAL ATTAINMENT:
DIPLOMA/DEGREE
LEVEL NAME AND ADDRESS OF SCHOOL INCLUSIVE DATES
EARNED/YEAR LEVEL
ELEMENTARY
SECONDARY
COLLEGE

SPECIAL STUDIES/SKILLS
TRAINING:

SCHOLASTIC
ACHIEVEMENT:

MEMBERSHIP IN
ORGANIZATIONS:

IN CASE OF AN EMERGENCY, PLEASE

NOTIFY:
NAME RELATION
ADDRESS
TELEPHONE/FAX
NUMBERS/EMAIL
OJT APPLICANT’S DATE
7
SIGNATURE APPLIED

Appendix D. (Form 4, cont.)

Attachment

NAME OF OJT
PARTICIPANT

COURSE &
YEAR

NAME OF HOST
COMPANY

Please answer the following questions truthfully. Your answers will be treated with the utmost
confidentiality.
1. Are you pregnant? □ Yes □ No □ n/a
If yes, please indicate the number of months. _________________________________________

2. Do you suffer from any illness, such as epilepsy, tuberculosis, hypertension, or heart
condition? □ Yes □ No
Others, please specify.
___________________________________________________________________________
__

3. Are you presently taking prescription medicines?

□ Yes □ No
If Yes, please specify the kind of medicine and the treatment.
_____________________________________________________________________________
__________________________________________________________________________________
________________________________________________________________________

4. Is there any special medical attention that the College should be aware of?
□ Yes □ No
If Yes, please specify.
__________________________________________________________________________________
________________________________________________________________________
__________________________________________________________________________________
________________________________________________________________________

This is to certify that the undersigned has provided only the true and correct information as deemed
necessary.

________________________
Signature Over Printed Name

8
Appendix E. (Form 5)

PRACTICUM SCHEDULE OF WORKS

Term Second SY 2024 - 2025

Student Profile:
Name of Contact
student: number(s):
Email address:

Company Profile:
Name of Company
company: address:
Manolo Fortich, Bukidnon

Name of supervisor:
Contact no. of
company/supervisor:
Job description:

Company Profile:
Description of assigned
jobs/tasks:

Start of work/End of work: From: February 4, 2025 To: April 21, 2025

Work Monday, Tuesday, Thursday and Friday 6:45am to 5:00pm

schedule:

Signature over Printed Signature over Printed Signature over Printed Name
Name of Student Name of Supervisor of Faculty Coordinator

9
Appendix F. (Form 6)

WAIVER OF LIABILITY

The Institute for Teacher Education of Northern Bukidnon State College, Kihare, Tankulan, Manolo
Fortich, Bukidnon, has requested this waiver in connection with its On-The-Job Training (OJT) and
Internship Program offered this Second Semester SY 2024-2025, and which is accepted and
confirmed. The student-trainee,

Name Course and Year

together with his parents or judicially appointed guardian, acknowledge that the permission granted
to him is made subject to the condition, which he hereby accepts and agrees to, that the company
will not assume any responsibility whatsoever for any injury or accident which may happen to him
within or outside the premises of the company during the period of said program. It is understood
that there is no employer-employee relationship between the company and the student-participant.

This waiver will be in effect for the duration of the 360-Hour Training as a minimum requirement
scheduled from February 4, 2025 to April 21, 2025.

Done this 30th day of January 2025, in Manolo Fortich, Bukidnon.

_______________________________ ___________________________________
Signature of OJT Participant Signature over Printed Name of Parent
or Judicially Appointed Guardian

Witnessed:

____________________________ ___________________________________
Department Chair Company/Agency/Bureau Representative

___________________________________
Name of Company/Agency/Bureau

10
Appendix G. (Form 7 sample)

January 30, 2025

Date

JO AUGUSTINE G. CORPUZ
Guidance Officer
Northern Bukidnon State College

Dear Mr. Corpuz:

The Institute for Teacher Education of NBSC would like to recommend

_________________________, a 4th year student of the Institute for Teacher Education taking up
_________________________________, to undergo a 360-Hour training in your institution. This
student has been evaluated and found qualified to undergo the said training this Second Semester
SY 2023-2024.

At the completion of the training, we request your end to evaluate the trainee and issue a Certificate
of Completion to the same. The evaluation forms will be made available towards the end of the
training.

Please do not hesitate to contact us through email at [email protected] / [email protected]

/ [email protected] or mobile phone no. 09261777513/ 09263145437/ 09688953610 for some
concerns regarding our On-the-Job Training (OJT) and Internship Program.

Thank you very much for your continued support and kind assistance.

Very truly yours,

CHRISTINE C. ROYO, PhD

Teacher Education Program Head

Noted by:

JO AUGUSTINE G. CORPUZ
Guidance Officer

11
Appendix H. (Form 8 )

ON-THE-JOB TRAINING LOG SHEET

WEEKLY PROGRESS REPORT

Term Second Semester AY 2024 - 2025

Name Course:
Company
Week ____________________________________________________________________________
__________________________________________________________________________________
________________________________________________________________________________

Objective #1 for the week: 1.

___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________

ACTIVITIES: REFLECTIONS:

12
Objective #2 for the week: 2.

__________________________________________________________________________________
__________________________________________________________________________________
_______________________________________________________________________.

ACTIVITIES: REFLECTIONS:

13
Objective #3 for the week: 3.

___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
_________________

ACTIVITIES: REFLECTIONS:

14
Objective #4 for the week: 4.
__________________________________________________________________________________
__________________________________________________________________________________
_______________________________________________________________________________

ACTIVITIES: REFLECTIONS:

15
Objective #5 for the week: 5.
__________________________________________________________________________________
__________________________________________________________________________________
________________________________________________________________________

ACTIVITIES: REFLECTIONS:

16
Objective #6 for the week: 6.
__________________________________________________________________________________
__________________________________________________________________________________
________________________________________________________________________

ACTIVITIES: REFLECTIONS:

17
Objective #7 for the week: 7.
__________________________________________________________________________________
__________________________________________________________________________________
_______________________________________________________________________________

ACTIVITIES: REFLECTIONS:

18
Objective #8 for the week: 8.
__________________________________________________________________________________
__________________________________________________________________________________
_______________________________________________________________________________

ACTIVITIES: REFLECTIONS:

19
Objective #9 for the week: 9.
___________________________________________________________________________
__________________________________________________________________________________
_______________________________________________________________________________

ACTIVITIES: REFLECTIONS:

20
Objective #10 for the week: 10.
__________________________________________________________________________________
__________________________________________________________________________________
_______________________________________________________________________.

ACTIVITIES: REFLECTIONS:

21
Objective #11 for the week: 11.
__________________________________________________________________________________
__________________________________________________________________________________
________________________________________________

ACTIVITIES: REFLECTIONS:

Signed: ______________
Student-Trainee
___________________________
Signature over Printed Name of
Company Dept. Head/Supervisor

___________________________
Department Coordinator Date Signed: ________________

22
Appendix I. (Form 9)

ON-THE-JOB TRAINING PERFORMANCE EVALUATION FORM

To the Evaluator: Thank you for taking time out of your hectic schedule. Your honest opinion of our
student’s training performance will greatly aid our evaluation. Please check which corresponds to
the answer that best describes the trainee’s performance.

Name of Student-Trainee: ________________________________________

Inclusive Dates of Training: _______________________________________
Name of Company: ____________________________________________

COMPETENCY 5 4 3 2 1
1. ability to apply knowledge of mathematics and science to solve problems
2. ability to design and conduct experiments, as well as to analyze and
interpret data
3. ability to design a system, component, or process to meet desired needs
within realistic constraints such as economic, environmental, social,
political, ethical, health and safety, manufacturability, and sustainability,
in accordance with standards.
4. ability to function on multidisciplinary teams
5. ability to identify, formulate, and solve problems
6. understanding of professional and ethical responsibility
7. ability to communicate effectively
8. broad education necessary to understand the impact of solutions in a
global, economic, environmental, and societal context
9. recognition of the need for, and an ability to engage in life-long learning
10. knowledge of contemporary issues
11. ability to use techniques, skills, and modern tools necessary for practice
12. knowledge and understanding of and management principles as a
member and leader in a team, to manage projects and in multidisciplinary
environments
Legend: 5 – Very Good 4 – Good 3 – Average 2 – Poor 1 – Very Poor
COMMENTS/REMARKS:

23
______ __________________________________ ___________________
Evaluator's Signature over Printed Name Date Signed

__________________________________ _____________________________
Position/Designation Section/Department

24
Appendix J. (Form 10)

ON-THE-JOB TRAINING EXECUTIVE SUMMARY REPORT

Term SECOND SEMESTER SY 2024 - 2025

Name Course &

Year
Company

What I did in the training:

What I learned from the training:

Signed:

_______________________________________
Student-Trainee OJT

________________________________________

________________________________________
Department Coordinator
______________________________
Date Signed

25
Appendix K. (Form 11)

ON THE JOB TRAINING AND INTERNSHIP PROGRAM EVALUATION FORM

Purpose
The following evaluation instrument is designed to assess the effectiveness of the On-Job-Training
Program of the College as well as the training program provided by the host companies. Please check
(✓) the appropriate box corresponding to your answer for each of the question asked and provide
the comments as needed. Return completed questionnaire to your Unit Coordinator together with
the documents required for your clearance. The results of this evaluation shall serve as basis for
improving the design and management of the OJT in the College to maximize the benefits of the said
Program. Thank you for your cooperation.
Legend: YES –Y NO –N NOT APPLICABLE – NA

Program Evaluation:
Item No. Question Y N NA
1 Has the College conducted an orientation about the OJT program,
the requirements and preparations needed?
Comments/Suggestions:

2 Has the College provided the necessary assistance such as referrals

or recommendations in finding the company for your OJT?
Comments/Suggestions:

3 Has the department showed coordination with the company in the

design and supervision of your OJT?
Comments/Suggestions:

4 Have the academic preparations i.e., prerequisite courses,

adequately equipped you to undertake company assignment and
its challenges?
Comments/Suggestions:

5 Has the Unit Coordinator provided monitoring of your OJT progress

in the company?
Comments/Suggestions:

6 Has the supervision of the Unit Coordinator been effective in

achieving your OJT objectives and providing feedback, when
necessary?
Comments/Suggestions:

7 Has the College conducted assessment of your OJT program upon

completion?
Comments/Suggestions:

8 Has the College provided you with the results of the company
assessment of your OJT?
Comments/Suggestions:

26
Appendix K. (Form 11, cont.)

Program Evaluation:
Item Question Y N NA
No.
1 Was the company appropriate for your type of training required and/or
desired?
Comments/Suggestions:

2 Did the training program designed by the company meet your objectives
and expectations?
Comments/Suggestions:

3 Has the company showed coordination with the College in the design
and supervision of your training program?
Comments/Suggestions:

4 Has the company and its staff welcomed you and treated you with
respect?
Comments/Suggestions:

5 Has the company facilitated the training, including the provision of the
necessary resources, such as, facilities and equipment and a safe
workplace conducive for training, needed to achieve your OJT
objectives?
Comments/Suggestions:

6 Has the company assigned a supervisor to oversee your work?

Comments/Suggestions:

7 Has the supervisor been effective in his/her supervision through regular

meetings, consultation or advising?
Comments/Suggestions:

8 Has the training provided you with the necessary technical and
administrative exposure of “real world” engineering problems and
practice?
Comments/Suggestions:

9 Has the training program allowed you to develop self-confidence, self-

motivation and positive attitude towards work?
Comments/Suggestions:

10 Has the experience improved your personal skills and human relations?
Comments/Suggestions:

27
Signature: ____________________________________________

Name
Course
Unit Coordinator
Company
Supervisor

28
Appendix L. (Memorandum of Agreement)

MEMORANDUM OF AGREEMENT

KNOW ALL MEN BY THESE PRESENTS:

This Agreement, known as the Agreement on the NORTHERN BUKINON STATE COLLEGE (NBSC) -
Industry Linkage Program, entered into and executed on the ___________________ in Kihare,
Manolo Fortich, Bukidnon , by and between:

NBSC with principal office at Kihare, Manolo Fortich,Bukidnon represented in this Agreement by its
President, ___________________________________________ and hereinafter referred to as NBSC;

and

NBSC HEALTH OFFICE, with principal address at Northern Bukidnon State College (NBSC) represented
herein by its School Nurse, Mr, Karl Clyde Stephen C. Acosta, RN, hereinafter called the
OFFICE/COMPANY.

WITNESSETH THAT

WHEREAS, NBSC seeks to form men and women of competence, conscience and commitment in
service of the Church and the Filipino people;

WHEREAS, the NBSC envisions to be a center of development for Teacher Education Program
education, research, and social development in Mindanao, the Philippines and world;

WHEREAS, the OFFICE/COMPANY aims to recruit professionals who possess not only desirable traits
and skills but leadership potentials, as well;

WHEREAS, the OFFICE/COMPANY realizes that the direct beneficiary of well-trained workforce is
industry, and the training of human resources is not the sole responsibility of academe, but a shared
task;

WHEREAS, the OFFICE/COMPANY has, among its corporate socio-economic concerns, the promotion
of BSBA education and finds the NBSC - Industry Linkage Program in line with such purpose;

NOW, THEREFORE, for and in consideration of the aforementioned premises, the parties have
agreed to forge the NBSC - Industry Linkage Program, subject to the following terms and conditions:

1. Undertake On-the-Job training, practicum or internship for senior students;

2. NBSC shall have the following duties and responsibilities:

a. Provide faculty to act as OJT, practicum or internship coordinators;
b. Prepare, in collaboration with the OFFICE/COMPANY OJT coordinator, a Training
Manual or Schedule of Works for the OJT, practicum or internship program;
c. Ensure that each trainee or intern wears the necessary identification card and
proper apparel while in company premises during training hours. The
OFFICE/COMPANY reserves the right to prohibit any of NBSC‘s trainees or interns
who fails or refuses to wear his or her identification card and proper apparel;
1
 d. Other duties that shall be identified in the pursuance of the program;

3. The OFFICE/COMPANY shall have the following responsibilities:

a. Assign OFFICE/COMPANY personnel as the student-trainees’ supervisors, who shall
serve the program on official time;
b. Accept the trainees or interns, subject to company regulations and policies;
c. Other responsibilities that may be identified in the planning and implementation of
the program.

4. Compliance with laws and regulations. NBSC shall cause the registration of the program with
the appropriate government agency and secure the requisite permits, if any, and furnish the
OFFICE/COMPANY with the documents evidencing compliance therewith;

5. Performance and discipline. NBSC shall be responsible for the discipline of its faculty, staff
and students. Pursuant thereto, it shall exercise due care and diligence in the selection and
supervision of trainees in order that injury, damage or loss to persons and property within
company premises will be avoided.

6. Non-liability clause. NBSC shall hold the OFFICE/COMPANY free and harmless from any
liability for any claim arising from death, physical disability or bodily harm that may be
inflicted on any of the trainees while undergoing training at the OFFICE/COMPANY premises.
To ensure faithful compliance therewith, NBCC shall obtain medical/hospitalization plan and
group accident insurance policy from a reputable insurance company for the trainees and
shall provide the OFFICE/COMPANY with a copy of policy covering the same.

7. No employer-employee relationship. It is further understood by the parties herein that the

trainees who qualify for training at the OFFICE/COMPANY premises are not employees or
apprentices of the COMPANY; neither is the accommodation given by the OFFICE/COMPANY
in allowing trainees to undergo training at the premises be considered as a guarantee of
employment with the OFFICE/COMPANY upon completion of the program.

8. Confidentiality. It is hereby understood that any information or data received by or

conveyed to any of NBSC’s trainees or made known to him or her in any manner in the
course of his training at the OFFICE/COMPANY is absolutely confidential and that said
trainee cannot, without the consent of the OFFICE/COMPANY, be examined as to any
communication made to him in the course of the training. Divulging such data and
confidential information, knowledge of it was acquired in the course of the training, or
making the same known in any manner willful or unknowing, constitutes a breach of this
Agreement and entitles the OFFICE/COMPANY to immediately termination of the
Agreement without prejudice to the person or entity’s liability under civil and criminal laws.

9. Miscellaneous. The parties hereby agree to do all acts and/or execute the documents as may
be necessary or required to clarify or fully implement the provisions of this Memorandum of
Agreement.

10. Effectivity. This Agreement shall take effect immediately upon signing thereof and shall be in
forms and effect for a period of 9 weeks subject to renewal by mutual agreement of the
parties.

2
IN WITNESS WHEREOF, the parties have hereunto set their hands on the date and place above
written.

By:

NBSC
COLLEGE PRESIDENT

OFFICE/COMPANY

3
_____________

Dear Dr. Genita:

This is to inform you that _________________________is cleared from all responsibilities/

requirements in_____________________________________. She has completed 360 hours as

prescribed by your institution.

Very respectfully yours,

_____________________
Cooperating Teacher

Attested by:

__________________________________________________
Cooperating Principal/ Department Head/ Designated Authority