List of Tasks/Activities to be done during Work Immersion

Name of Grade and

Student Section
Immersion
School
Site
Strand/
Track
Specialization
Duration
of Work
Immersion

List of Tasks/Activities

Time Actual
Competencies Tasks/Activities Remarks
Allotment Schedule

Students shall 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 Over Industry Supervisor’s Signature Over

Printed Name Printed Name