Form 1.

1
TRAINEE’S PROFILE FORM
Name: _____________________________________ Birthdate: __________ Age: ________
Contact Numbers: ____________________________ Gender: _______ Civil Status: ________
Email Address: _______________________________ Ethnicity: ________________________
Address: _____________________________________________________________________________
Special Needs / disabilities: ______________________________________________________________

Training Program / Qualification: ______________________________________

Educational Background:
Level School Address Year Completed
Doctoral
Masteral
College
Tech-Voc
High School
Elementary

Trainings / Seminars / Workshops Attended:

Training Venue Date

Work Experience:
Period of Average
Company Address Employment Monthly Salary

National Certificates acquired and NC level

____________________________________________
____________________________________________
____________________________________________

Previous Learning experiences related to the Qualification / Training Program applied for:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________

_________________________
Signature
Date: ________

Date developed: Document

Forms 1.1 to 1.4 for Feb. 3, 2017 No
ELECTRICAL INSTALLATION Issued by: Page 1 of 4
AND MAINTENANCE NC II LCNHS
Developed by: Revision No.
Hibirson E. Lagrosa
Form 1.2

Evidence of Current Competencies acquired related to job/occupation

ELECTRICAL INSTALLATION AND MAINTENANCE NC II

List of Competencies Proof / Evidence Means of Validating

Perform roughing-in
activities, wiring and cabling
works for single-phase
distribution, power, lighting
and auxiliary systems

Install electrical protective

devices for distribution,
power, lighting, auxiliary,
lightning protection and
grounding systems

Install wiring devices of floor

and wall mounted outlets,
lighting fixtures/switches,
and auxiliary outlets

Date developed: Document

Forms 1.1 to 1.4 for Feb. 3, 2017 No
ELECTRICAL INSTALLATION Issued by: Page 2 of 4
AND MAINTENANCE NC II LCNHS
Developed by: Revision No.
Hibirson E. Lagrosa
Form 1.3

Summary of Current Competencies Versus Required Competencies

List of Competencies Current Training Gaps/

with Learning Outcomes Competencies Requirements
Perform roughing-in activities, wiring and cabling works
for single-phase distribution, power, lighting and /
auxiliary systems

/
Install electrical protective devices for distribution,
power, lighting, auxiliary, lightning protection and
grounding systems

Install wiring devices of floor and wall mounted outlets, /

lighting fixtures/switches, and auxiliary outlets

Date developed: Document

Forms 1.1 to 1.4 for Feb. 3, 2017 No
ELECTRICAL INSTALLATION Issued by: Page 3 of 4
AND MAINTENANCE NC II LCNHS
Developed by: Revision No.
Hibirson E. Lagrosa
Form 1.4

Training Needs

Training Needs Module Title /

(Learning Outcomes) Module of Instruction
1. Install electrical metallic /non- metallic (PVC
conduit) Performing roughing-in activities,
wiring and cabling works for single-
2. Install wire ways and cable tray phase distribution, power, lighting
and auxiliary systems
3. Install auxiliary terminal cabinet and
distribution panel

4. Prepare for cable pulling and installation

5. Perform wiring and cabling lay out

6. Notify completion of work

Installing electrical protective
1. Plan and prepare work devices for distribution, power,
lighting, auxiliary, lightning
2. Install electrical protective devices protection and grounding systems

3. Install lighting fixture and auxiliary outlet

4. Notify completion of work

1. Select wiring devices Installing wiring devices of floor and

wall mounted outlets, lighting
2. Install wiring devices fixtures/switches, and auxiliary
outlets
3. Install lighting fixtures/switches

4. Notify completion of work

Date developed: Document

Forms 1.1 to 1.4 for Feb. 3, 2017 No
ELECTRICAL INSTALLATION Issued by: Page 4 of 4
AND MAINTENANCE NC II LCNHS
Developed by: Revision No.
Hibirson E. Lagrosa