ATOK NATIONAL HIGH SCHOOL

Poblacion, Atok, Benguet

SENIOR HIGH SCHOOL

Work Immersion Program

LIST OF TASKS/ACTIVITIES

Track and
Name of Student Strand/
Specialization

Contact Number Home Address

Work Immersion
site
Duration of Work
Immersion

Industry Work Contact Number

Immersion
Coordinator/Supervisor
Work Immersion Contact Number
Teacher

TASKS/ACTIVITIES

Date Task/Work Time Allotment Remarks

(Starting Time –Ending (Problems/Difficulties
Time) Encountered)

(insert rows as needed)

Certificate true and correct:

__________________________________ __________________________________

__________________________________ __________________________________
Student’s Signature over Printed Name Student’s Signature over Printed Name

__________________________________

__________________________________
Work Immersion Teacher’s Signature
over Printed Name