Department of Education

Republic of the Philippines

Province of Bohol

SIKATUNA NATIONAL HIGH SCHOOL

Poblacion I, Sikatuna, Bohol

WORK IMMERSION TRAINING WAIVER

KNOWN ALL MEN BY THESE PRESENTS:

This WORK IMMERSION WAIVER made and executed this _____day of ______________, 2025 at
Sikatuna National High School, Poblacion I, Sikatuna, Bohol, that (learner’s name)
_______________________________________________, Filipino/Filipina and a resident of
(address)_____________________________________________________________, Bohol, herein after
referred to as the Work Immersion Trainee.

and

(Company’s name) ___________________________________________, (company’s address)

_____________________ _____________________, Bohol, herein referred to as the COMPANY.

Witnesseth

THAT, the SIKATUNA NATIONAL HIGH SCHOOL of which public school the WORK IMMERSION is
a trainee, in (company’s name) __________________________________ has requested the company to
allow Work Immersion training for a minimum of 80-120 hours as part of his/her requirements for
graduation.

THAT, the COMPANY is willing to accommodate the request of the school and to allow work
immersion trainee to undergo actual training, subject to the following conditions:

1. During the period of his/her work immersion training, the COMPANY shall not be bound to
pay work immersion trainee any salary, allowance or compensation but may do so if wishes.
2. The work immersion trainee shall abide by all rules and regulations observed by the
COMPANY employees during his/her work immersion training with the COMPANY and shall
exercise care and diligence the task assigned to him/her.
3. Each party shall answer for losses and damages arising from any accident, act, or omission
directly attributable to its fault or negligence, which may cause death or bodily injury to any
persons, or loss or damage to property, by or on account of the performance of the
respective obligations by the parties pursuant to this agreement.
4. Such responsibility shall continue to remain that of the responsible party’s even after the
termination of this agreement, if such losses and damages were incurred during the
effectivity of this agreement.
5. It is clearly understood that during the period of his/her training and presence in the
COMPANY, no employer-employee relationships exist between the work immersion trainee
and the COMPANY.
 6. The work immersion trainee’s training should be classified as confidential in nature and
proprietary to the COMPANY and thereby each student hereby undertakes to prevent
transfer of such information on the methodologies, manuals, operational and technical
matters by any of its members to any party outside of the COMPANY. The COMPANY shall
make those available to them to be used for sole purpose of students training.
7. This WORK IMMERSION TRAINING WAIVER will be in effect for the whole duration of the
training.

IN WITNESS WHEREOF, I/We have affirmed my/our signature/s hereunto on the date and place
first aforementioned.

__________________________ __________________________
Work Immersion Trainee Company Owner/ Manager

CTC No.: ______________________

Issued on: _____________________

Noted:

LEONOR T. APALE
School Principal

________________________________
Signature over printed
Name of Parent/Guardian
 ANNEX C: LIST OF TASKS/ACTIVITIES TO BE DONE DURING WORK IMMERSION

NAME OF STUDENTS
SCHOOL’S NAME SIKATUNA NATIONAL HIGH SCHOOL
TRACK ACADEMIC TRACK
DURATION OF WORK IMMERSION
GRADE AND SECTION GRADE 12- LAWAAN
IMMERSION SITE
STRAND/SPECIALIZATION

SCHOOL PARTNERSHIP MAE M. JALA CONTACT 0905-309-5188

FOCAL PERSON NUMBER
WORK IMMERSION MA. ALODIA A. DUMAPIAS CONTACT 0976-09-36338
TEACHER NUMBER

LIST OF TASKS/ ACTIVITIES

NO COMPETENCIES TASKS/ACTIVITIES TIME ACTUAL REMARKS
ALLOTMENT SCHEDULE
1 TEAMWORK Consistently
works with others
to accomplish
goals and tasks.
Treats all team
members in a
respectful
courteous
manner.
Actively
participates in
activities and
assigned tasks
required.
Willing to work
with team
members to
improve team
collaboration on
an assigned basis.
Considers the
feedback and
view of team
members when
completing an
assigned task.
2 COMMUNICATION Actively listens to
supervisor and/or
co-workers.
Comprehends
written and oral
information.
Consistently
delivers accurate
information both
written and oral.
Reliably provides
feedback as
 required, both
internally and
externally.
3 ATTENDANCE AND Is punctual
PUNCTUALITY regularly.
Maintains good
attendance.
Informs
supervisor
promptly when
absenteeism and
tardiness may
occur.
4 PRODUCTIVITY/ Consistently
RESILIENCE produce quality
results.
Meets deadlines
and manages
time well.
Can do
multitasking.
Can work under
pressure and
delivers the
required tasks.
Effective and
efficient in time
management.
Efficiently informs
supervisor of any
challenge or
hindrance related
to given task or
assignment.
5 INITIATIVE/PROACTIVITY Completes
assignments with
minimum
supervision.
Completes tasks
independently
and consistently.
Seeks support as
the need arises.
Recognize and
take immediate
action to
effectively
address problems
and opportunities.
Engages and
continuous
learning.
Contributes new
ideas and shares
skills to improve
the departments/
organization.
6 JUDGEMENT/ DECISION Analyzes
MAKING problems
effectively.
Has the ability to
make creative
and effective
solutions to
problems.
Demonstrates
food judgment in
 handling routine
problems.
7 DEPENDABILITY / Has the ability to
RELIABILITY follow through
and meet
deadlines.
Commits his/her
action.
Can adjust easily
to changes in the
workplace.
Displays a high
level of
performance at all
times.
8 ATTITUDE Offers assistance
willingly.
Shows a positive
work attitude.
Shows sensitivity
to and
consideration for
other’s feelings.
Accepts criticism
positively.
Shows pride in
work.
9 PROFESSIONALISM Respect persons
in authority.
Uses all tools,
equipment, and
facilities
responsibly.
Follows all
policies and
procedures when
issues and
conflict arises.
Physical
appearance
conforms with the
workplace and
placement rules.

Students shall not be given other activities outside of those previously agreed upon, which are anchored
on the stated competencies.
Certified true and correct:

_______________________________ _____________________________
Student’s Signature Over Printed Name Parent’s Signature Over Printed Name

_________________________________ _____________________________
Work Immersion Teacher’s Signature Industry Supervisor’s Signature
Over Printed Name Over Printed Name