Journal Writing

Objectives:

Using a journal notebook or a diary, maintain a journal about your journey in the
Work Immersion /Research/Career Advocacy and Culminating Activity. Follow
the format provided below. This will be checked weekly from the start of the
course up to the last day of the course.
_______________________________________________________________
: Applied Competencies :
Date : Learnings/Problems : Realizations______

: :
: :
: :
: :
: :
: :
: :
: :
: :
: :
: :
________________________________________________________________

NOTE:
Reflection/Insights
You will come up with your own insights or reflection about the activity .
You may base your insights upon the things you wrote under 'Lessons
Learned/Realizations' in the journal.
 Portfolio:

1. Table of Contents
2. Syllabus
3. Introduction
4. Resume
5. Accomplished forms
a) Waiver
b) Daily Task
c) Daily Time Record
d) Week Diary/Journal
6. Documentations
a) Pictures of work site and non written output
b) Illustration of activities performed
7. Sample written output (if any)
8. Other relevant pictures/documents
9. Reflection paper
 PAMANTASAN NG LUNGSOD NG VALENZUELA
Poblacion II, Malinta, Valenzuela City

WAIVER

I, _________________________________, the ________________________________ of

Mr./Ms. _____________________________________, a Senior High School student of
thePamantasan ng Lungsod ng Valenzuela.

That my son/daughter/ward is presently enrolled in the subject Work

Immersion/Research/Career Advocacy/Culminating Activity that involves actual On-The-Job
Training and Observation.

That I understand the rigidity of the training and its contribution to my son/daughter/ward.

That in this regard, I hereby absolve the Pamantasan ng Lungsod ng Valenzuela from all
liabilities, which might arise during the period of said On-The-Job Training and Observation
as well as from any materials destroyed or misplaced by my son/daughter/ward.

IN WITNESS WHEREOF, I here unto affix my signature this ____ day of __________ here at
the City of Valenzuela.
_______________
Signature / Affiant

SUBSCRIBED AND SWORN to before me this _____ day of __________ here at the
Valenzuela City, affiant appearing to me with Community Tax Certificate No. ________ issued
on ____________, issued at ______________.

Doc No. _____________

Page No. ____________

Book No. ____________

Series of 2021
 PAMANTASAN NG LUNGSOD NG VALENZUELA
Poblacion II, Malinta, Valenzuela City

List of Task and Activities during Work Immersion

Name of Student Grade and
Section
School Immersion Site

Track Strand/
Specialization
Duration of Work
Immersion

School Partnership Contact Number

Focal Person
Work Immersion Contact Number
Teacher

List of Tasks/Activities
Competencies Tasks/Activities Time Allotment Actual Schedule Remarks

Students shall not be given other activities outside of those previously agreed upon, which are
anchored on the stated competencies

Certified true and correct:

________________________________ ________________________________
Student’s Signature Over Printed Name Parent’s Signature Over Printed Name

_______________________________ ______________________________
Work Immersion Teacher’s Signature Industry Supervisor’s Signature Over
Over Printed Name Printed Name
PAMANTASAN NG LUNGSOD NG VALENZUELA
Poblacion II, Malinta, Valenzuela City

Name of Student:
_________________________________________________________________

Institution/Company: ________________________________________________________________

Period of Training: From: ___________________________ To: ______________________________

PERFORMANCE EVALUATION FORM

TO BE ANSWERED BY WORK IMMERSION PARTNER SUPERVISOR

Directions: Put a Check (/) on your assessment. Kindly refer to the legend for your choices

Legend:
Numerical Scale Verbal Interpretation
5 Excellent
4 Above Average
3 Average
2 Below Average
1 Not Acceptable

INDICATORS 5 4 3 2 1
Overall Attitude
Attendance
Punctuality
Quality of Work
Appearance
Dependability
Ability to follow written Instructions
Ability to follow safety procedures
Initiative in anticipating work
Work well with others (Team)
TOTAL

Please give comments regarding the performance of the students

____________________________________________________________________________

Please give comments regarding the Work Immersion Program (Strengths/Improvements if

needed)

____________________________________________________________________________

Rater: ____________________________________

Position: __________________________________

Signature: _________________________________

Date: _____________________________________