OJT FORM 01

CLEARANCE FORM FOR OJT

Student’s Name: Sem./Modules:

Student Number: Course:
Contact Number:
This is to certify that the aforementioned is free from any obligation or accountabilities and has been evaluated by the following
department as attested by its facilitator bearing their signature.

Accounting / Cashier : __________________________

Registrar : __________________________
Pre - OJT Evaluator : __________________________
Guidance/SAO : __________________________
OJT Head : __________________________

Date Cleared:
Target Date Deployment:
Actual Date Deployment: No, of Hours
Student’s Copy

Quintos Bldg., Mc Arthur Highway, San Vicente, Apalit, Pampanga (045) 652-05-11 / ( 02 ) 463-93-28

OJT FORM 01
CLEARANCE FORM FOR OJT

Student’s Name: Sem./Modules:

Student Number: Course:
Contact Number:
This is to certify that the aforementioned is free from any obligation or accountabilities and has been evaluated by the following
department as attested by its facilitator bearing their signature.

Accounting / Cashier : __________________________

Registrar : __________________________
Pre - OJT Evaluator : __________________________
Guidance/SAO : __________________________
OJT Head : __________________________

Date Cleared:
Target Date Deployment:
Actual Date Deployment: No, of Hours
School’s Copy

Quintos Bldg., Mc Arthur Highway, San Vicente, Apalit, Pampanga (045) 652-05-11 / (02) 463-93-28