TESDA-OP-CO-05-F26

Rev. 00 – 03/01/17

TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY

PangasiwaansaEdukasyongTeknikal at PagpapaunladngKasanayan

 APPLICATION FORM
REFERENCE NUMBER : COK 2 0 0 3 5 4 1 1 1 0 0 0 PICTURE
Qual – YY Region Province Number Series Number Series
alpha code
Assigned to AC UNIQUE
colored,
LEARNERS
IDENTIFIER (ULI):
passport size,
- - - -
to be filled – out by the Processing Officer
white
background

Applicant’s Signature Date of Application

Name of School/Training Center/Company: WEST CENTRAL COLLEGE OF ARTS AND SCIENCE INC.

Address: 2nd – 4th FLOOR KYMATA BLDG., STA. CRUZ, LUBAO, PAMPANGA
Title of Assessment applied for: PREPARING COLD MEALS LEADING TO COOKERY NCII
 Full Qualification  COC  Renewal
1. Client Type
 TVET Graduating Student  TVET graduate  Industry worker  K-12  OWF
2. Profile
2.1. Name:

 SURNAME
 FIRSTNAME 
 MIDDLE
 MIDDLE INITIAL
NAME EXTENSION
(e.g. Jr., Sr.)
NAME

Mailing
2.2.
Address:
Number, Street Barangay District

City Province Region Zip Code

2.3. Mother’s Name 2.4. Father’s Name
2.5.Sex 2.6.Civil Status 2.7. Contact Number(s) 2.8.Highest Educational 2.9.Employment Status
Attainment
 Male  Single Tel:  Elementary Graduate  Casual
 Female  Married Mobile:  High School Graduate  Job Order
 Widow/er E-mail:  TVET Graduate  Probationary
 Separated Fax:  College Level  Permanent
 College Graduate  Self - Employed
Others:
 Others: ____________  OFW
2.10 Birth date (mm/dd/yy): M M D D Y Y 2.11 Birth place: 2.12 Age:
3. Work Experience (National Qualification-related)
3.1. 3.2. 3.3. 3.4. 3.5. 3.6
Monthly No. of Yrs. Working
Name of Company Position Inclusive Dates Status of Appointment
Salary Exp.

(For more information, please use separate sheet)

 4. Other Training/Seminars Attended (National Qualification-related)
4.1. 4.2. 4.3. 4.4 4.5
Title Venue Inclusive Dates No. of Hours Conducted By

(For more information, please use separate sheet)

5. Licensure Examination(s) Passed

5.1. 5.2. 5.3. 5.4. 5.5. 5.6.
Title Year Taken Examination Venue Rating Remarks Expiry Date

(For more information, please use separate sheet)

6. Competency Assessment(s) Passed

6.1. 6.2. 6.3 6.4. 6.5. 6.6.
Qualification
Title Level Industry Sector Certificate Number Date of Issuance Expiration Date

(For more information, , please use separate sheet)

ADMISSION SLIP

REFERENCE
NUMBER :
COK 2 0 0 3 5 4 1 1 1 0 0 0

Name of Applicant: Tel. Number: PICTURE

(Passport
Assessment Applied for: PREPARING COLD MEALS
Official Receipt Number: size)
LEADING TO COOKERY NCII
Date Issued:
To be accomplished by the Processing Officer

Name of Assessment Center: WEST CENTRAL COLLEGE OF ARTS AND SCIENCE INC.
Check submitted requirements: Remarks:

 Accomplished Self-Assessment Guide  Bring own Personal Protective Equipment

 Three (3) pieces colored passport size pictures

 Others. Pls. specify

Assessment Date: Assessment Time:

JYPSY JEAN M. PARDILLA

Printed Name & Signature of Applicant
Printed Name & Signature of Processing Officer

Date: Date:

Note: Please bring this Admission Slip on your assessment date.

 CONSENT FORM

Do you authorize the Technical Education and Skills Development Authority (TESDA) to share
your career (such as Full Name, NC/COC Certificate No., Qualification Details, Date of
Issuance, Contact Datails and ID Pictures) with any legitimate third party for
________________________ purpose/s?
Kindly check your reference and sign over your printed name below.

 Yes, I want to share my career information and I expressly give my consent thereto:

__________________________
Signature over Printed Name

Date:______________________

 No, I don’t give my consent and I want my career information to be restricted only for
TESDA’s use and profiling purposes:

__________________________
Signature over Printed Name

Date:_____________________

CONSENT FORM

Do you authorize the Technical Education and Skills Development Authority (TESDA) to share
your career (such as Full Name, NC/COC Certificate No., Qualification Details, Date of
Issuance, Contact Datails and ID Pictures) with any legitimate third party for
________________________ purpose/s?
Kindly check your reference and sign over your printed name below.

 Yes, I want to share my career information and I expressly give my consent thereto:

__________________________
Signature over Printed Name

Date:______________________

 No, I don’t give my consent and I want my career information to be restricted only for
TESDA’s use and profiling purposes:

__________________________
Signature over Printed Name

Date:_____________________
 TESDA-OP-QSO-02-F07
Rev. No. 00-03/01/17
Reference No. COK 2 0 0 3 5 4 1 1 1 0 0 0
to be filled out by the Processing Officer

Qualification: COOKERY NC II
Certificate of Competency PREPARE COLD MEALS
Instruction:
Read each of the questions in the left-hand column of the chart.
Place a check in the appropriate box opposite each question to indicate your answer.
Can I? YES NO
PREPARE COLD MEALS
 Clean and/or sanitize kitchen equipment and utensils*
 Store and stack cleaned equipment and utensils
 Follow cleaning schedules
 Use appropriate chemicals and equipment in cleaning and maintaining kitchen
premises, tools and equipment*
 Select and assemble tools and equipment*
 Inspect tools and equipment*
 Rotate and move supplies
 Check, record and label supplies
 Identify and select ingredients as per required menu items *
 Prepare variety of sandwich types*
 Select suitable bases from a range of bread type*
 Prepare appetizers and salads with suitable sauces and dressings*
 Utilize quality trimmings or other left over
 Select and prepare variety of cold dishes according to recipe requirements*
 Identify and use appropriate cooking methods*
 Organize and prepare food items according to menu requirements*
 Plate and present food*
 Select packaging materials for foodstuffs
 Adapt appropriate packaging procedures*
 Store food in appropriate condition*
 Minimize wastage through purchases*
 Follow workplace safety and hygiene procedures*
 Perform first aid procedures in the event of accident
 Prepare reports
 Coordinate end of service procedures
I agree to undertake assessment in the knowledge that information gathered will only be used for
professional development purposes and can only be accessed by concerned assessment personnel and
my manager/supervisor.

Candidate’s Signature: Date:

Evaluated by:
 Qualified for Assessment
AIRON C. LANGIT
AC Manager  Not yet Qualified for Assessment
Date:

TRSCOK212-0415

Cookery NC II