Republic of the Philippines

POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

COLLEGE OF ENGINEERING
DEPARTMENT OF ELECTRICAL ENGINEERING
WAIVER
KNOW ALL MEN BY THESE PRESENTS:

I, JOHN JOSHUA F. ABOC , Filipino, 23 years of age,

single. With residence at
Blk 3 Lot 42 Greentown Villas 1, Mambog 3, City of Bacoor and
presently enrolled at the Polytechnic University of the Philippines, College of Engineering and
Architecture, Sta. Mesa, Manila, hereby voluntarily renounce and waive, with the consent and
conformity of my parents/guardian, all claims that I may have against Polytechnic University of
the Philippines, and/or its officials, arising from any cause/s that may occur in connection with
my On the Job Training at Alecto General Technology Corporation .

This waiver is valid only on the duration of the said On-the-Job Training.

IN WITNESS WHEREOF, I hereby affix my signature this 29 day of March, 2017 at

______________________________.

WITH MY CONSENT AND CONFORMITY:

Parent/Guardian’s signature over printed name Signature of student

CTC NO. ________________

Issued at ________________
on ________________

SUBSCRIBED AND SWORN to before me, this _____ day of __________, ______, by _________
_____________________, who exhibited to me his Residence Certificate No.
__________________
Issued at _________________________ on _______________________.

Notary Public
Until Dec 31, _______
PTR No.
________________
Doc. No. _____
Page No. _____
Book No. _____
Series of _____

PUP NDC Campus Anonas Street, Sta. Mesa, Manila Phone: (Direct Line) 3352371; website: www.pup.edu.ph
e-mail: coc@pup.edu.ph/com.center@gmail.com

“THE COUNTRY’S FIRST POLYTECHNIC UNIVERSITY”