You are on page 1of 1

Republic of the Philippines

NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY


On–the–Job Training and Career Development Center
Cabanatuan City
ISO 9001:2015 Certified

ACCOMPLISHMENT FORM

A. Student Information
Name: ________________________________________ Course/Yr. /Sec.: _____________________
Company: ________________________________________________________________________
Address: __________________________________________________________________________
Telephone Number: _________________________________________________________________
Contact Person: __________________________ __________________________________________
Position: __________________________________________________________________________

B. Requirements Accomplished

Requirements Date Submitted Remarks

• Certificate of Registration

• Certificate of Participation

• On–the–Job Training Program and Information Sheet

• Application for Supervised Industrial Training

• Waiver and Permission Form

• Student/University Contract

• Internship Waiver Form

• Medical Results

General Remarks:

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Prepared by:

_______________________________________
Signature over Printed Name of the Student

Received and Verified by:

_______________________________________
Signature over Printed Name of the OJT Coordinator
Date Signed: ___________________________

NEUST–OJT–F010
Rev. 00 (02.11.19)

You might also like