Dole Form and Waiver

CEAOJT Form 007
PRACTICUM/OJT AGREEMENT
WAIVER
To Whom It May Concern:
This is to certify that I, _____________________________________, _____ years
of age, single/married, residing at _____________________________________________
________________________________________________________________________
, bonafide student of Holy Angel University, Angeles City.
In compliance with the continuation and requirements of my course in Bachelor of
Science in _____________________________________, I have to complete a minimum
of ______ hours On-the-Job training at ______________________________________
_______________________________________________________________________.
I further agree and affirm that, I will be responsible for my acts during my training; I
will follow the rules and regulations pertinent to the practicum training program; and that
the Holy Angel University and the above mention Company/Institution are in no way
responsible/liable nor shall pay compensation for any incident, harm or injury that may be
caused on my part as a result of my negligence that may occur during my Practicum/OJT
period.
__________________________________________
Signature of Student Over Printed Name
__________________
Date
CONFORME
___________________________________
__________________________________
Signature of Parent/Guardian Over Printed Name
Signature of School Practicum Coordinator
________________________________________
Company Representative or Officer in Charge
REPUBLIC OF THE PHILIPPINES

DEPARTMENT OF LABOR
BUREAU OF LABOR STANDARDS
MANILA
APPLICATION FOR SPECIAL CERTIFICATE TO EMPLOY LEARNER OR APPRENTICE WITHOUT
COMPENSATION AS A REQUIREMENT FOR A SCHOOL CURRICULUM OR AS A PRE-REQUISITE
TO A BOARD EXAMINATION.
(This is an application form only. It is not to employ apprentice or learner without compensation.)
NOTE:
This application must be accompanied by a certification from the school attended by the apprentice
or learner stating the number of hours of On-the-job Training required by the curriculum of the
course being taken. Attach recent photos of the apprentice or learner. Application not fully
accomplished shall not be entertained.
1. Name of Establishment: _____________________________________________________________

2. Address of Location: _______________________________________________________________
3. Name of Proposed Apprentice/Student-Trainee: _________________________________________
4. Name of Institution: _______________________________________________________________
5. Nature of Training: ________________________________________________________________
(State whether apprentice in the Engineering/Pharmacy/Office Practice, etc.)
6. Number of hours, Days, Months, or Years of training required: _____________________________
7. Number of Hours of Training to be spent daily: __________________________________________
The undersigned certifies that the information given above is true and correct and that the employment of
the above mentioned apprentice/learner will not prejudice the existing office personnel of the establishment
and that the picture attached is that of the apprentice/learner; and that the said practice/training will not be a
ground for employment on any position that may become vacant in the future.
______________________________
Signature of Employer
_______________________________
Signature of Apprentice
_______________________________
Address
______________________________
Designation
______________________________
Date
CEAOJT Form 009
COLLEGE OF ENGINEERING AND ARCHITECTURE

HOLY ANGEL UNIVERSITY
Angeles City
REPLY FORM
Name of the Company: ___________________________________________________

Address: ______________________________________________________________
Phone Nos.: ___________________________________________________________
Contact Person/s & Position: ______________________________________________
______________________________________________________________________
Name of Student: _______________________________________________________
Based on our assessment of the student/s qualifications and abilities:
________
we will accommodate the student/s.
________
we cannot accommodate the student /s due to:

___________________________________________________________
___________________________________________________________
________
others:
___________________________________________________________
_________________________________
Company Representative Signature
_____________________
Date

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Dole Form and Waiver

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CEAOJT Form 007

Signature of Parent/Guardian Over Printed Name

Signature of School Practicum Coordinator

REPUBLIC OF THE PHILIPPINES

1. Name of Establishment: _____________________________________________________________

CEAOJT Form 009

COLLEGE OF ENGINEERING AND ARCHITECTURE

Name of the Company: ___________________________________________________

we will accommodate the student/s.

we cannot accommodate the student /s due to:

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