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APPLICATION-FORM-1

The document is an application form for Supervised Industrial Training at the Technological University of the Philippines, requiring personal and academic data from the student. It includes a waiver acknowledging the student's acceptance of the training conditions and the renouncement of claims against the university and cooperating company. The application must be signed by the student and a parent or guardian, along with faculty approval.

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negrete.joy123
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10 views

APPLICATION-FORM-1

The document is an application form for Supervised Industrial Training at the Technological University of the Philippines, requiring personal and academic data from the student. It includes a waiver acknowledging the student's acceptance of the training conditions and the renouncement of claims against the university and cooperating company. The application must be signed by the student and a parent or guardian, along with faculty approval.

Uploaded by

negrete.joy123
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Index No. F-IRJ-6.

6-AIT
TECHNOLOGICAL UNIVERSITY OF THE PHILIPPINES
Ayala Blvd., Ermita, Manila, 1000, Philippines Issue No. 01
Tel No. +632-301-3001 local 204 | Fax No. +632-521-4063 Revision No. 00
Email: [email protected] | Website: www.tup.edu.ph
Date 11242017

APPLICATION FOR SUPERVISED INDUSTRIAL Page 1/1


VAA-IRJ
TRAINING QAC No. CC-11242017

ID PHOTO
1½X1½

Date: ______________, 20___

The Director
Industrial Relations and Job Placement
This University

Sir:

May I apply for placement in the Supervised Industrial Training I/ II. The following are my particulars and
preferences for your information and guidance.

I. PERSONAL DATA

Name: ________________________________________ ID # ______________


Sex : _________ Civil Status: ________ Religion: __________
Home Address: ______________________________________________________________
______________________________________________________________
Telephone no. : __________________ Cell phone no.: _______________________

II.ACADEMIC DATA

Course: _____________________ Major : _______________________


Year & Section: ______________ Session: _______Day _______Eve

III. PREFERENCE FOR PLACEMENT

Company: ________________________________________________________________
Address : ________________________________________________________________
Contact Person: _____________________________________________________________
Position : _____________________________ Tel. #.: ____________________

___________________________________________________
(Signature of student over Printed Name)
Recommending Approval:

_______________________________
Faculty In-Charge Approved;

ENGR. RUEL B. AGGABAO


Director

I, ________________________________________ age __________ and residing at


________________________________________________________ and applied for Supervised Industrial Training with a
cooperating firm/company/ agency through the request of the Technological University of the Philippines,

Transaction ID
Signature
Index No. F-IRJ-6.6-SIW
TECHNOLOGICAL UNIVERSITY OF THE PHILIPPINES
Ayala Blvd., Ermita, Manila, 1000, Philippines Issue No. 01
Tel No. +632-301-3001 local 204 | Fax No. +632-521-4063 Revision No. 00
Email: [email protected] | Website: www.tup.edu.ph
Date 11242017
Page 1/1
VAA-IRJ WAIVER QAC No. CC-11242017

Industrial Relations and Job Placement Division and in consideration therefore, hereby freely and voluntary
assume myself the following duties.

1. That I recognize the authority of my cooperating company or agency where I will be placed and
submit myself to all the rules and regulation that are imposed upon me in connection with my
training, and

2. That I renounce and waive any claim against the cooperating company/agency and the
Technological University of the Philippines for any injury that I may sustain, or loss that I may suffer, personal
or pecuniary, in the performance of my duties or function while under training.

3. No Employee-Employer relationship.

Signed at Manila, Philippines, this ______ day of ______________20__.

___________________________________
Signature of Student

Left Hand Right Hand


Thumb mark Thumb mark

CONFORME:

____________________________________ Address: ___________________________


Signature of Parent/ Guardian ___________________________
___________________________

WITNESS:

__________________________ _______________________________
Faculty-in-Charge Program Coordinator

Transaction ID
Signature

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