DOLE-GIP_Form C

DOLE REGIONAL OFFICE _____

GOVERNMENT INTERNSHIP PROGRAM (GIP) BENEFICIARIES MONITORING FORM

NAME NATURE OF DURATION OF CONTRACT REMARKS

ADDRESS AGE GENDER EDUCATIONAL DOCUMENTS OFFICE/PLACE WORK/
(Last Name, First Name, MI) ATTAINMENT SUBMITTED OF ASSIGNMENT
ASSIGNMENT
START DATE END DATE (e.g. Contract completed or
preterminated

Prepared by: Noted by:

______________________________________________ ______________________________________________
Name, Position/Designation and Signature Regional Director
Date: ____________________________

*Please note that this monitoring report must contain actual name of beneficiaries as of the date the report was submitted. All reportorial requirements must be submitted every quarter or five (5) days after the reference quarter to the BLE via email at
gip.ble.dole@gmail.com and posted at the RO website.