Reference No.: BatStateU-FO-OJT-06 Effectivity Date: May 18, 2022 Revision No.

: 01

ON-THE-JOB TRAINEE ACCEPTANCE FORM

Date

This is to certify that Mr. /Ms. CASTILLO KATHLEEN KAYE a FOURTH year
Name of Student Year Level

BS SANITARY ENGINEERING student in the College of ENGINEERING

Program Name of College

- ALANGILAN Campus, has been officially ACCEPTED AS OJT TRAINEE in

Name of Campus

Earthclean Environmental Management Corp. which is located at Inicbulan Bauan, Batangas

Name of Company Complete Address of the Company

The details of his/her assignment are as follows:

Branch Department/Section: OPERATIONS
Name of Supervisor: ENGR. HARVEY C. SERAJOSEPH
Training Schedule (Hours and Days): (8 HOURS/DAY) MONDAY - THURSDAY
Required Number of Hours: 320 HOURS
Effective Date of Start: SEPTEMBER 1, 2022
Pursuant to Republic Act No. 10173, also known as the Data Privacy Act of 2012, the Batangas State University, the National
Engineering University, recognizes its commitment to protect and respect the privacy of its customers and/or stakeholders and
ensure that all information collected from them are all processed in accordance with the principles of transparency, legitimate
purpose and proportionality mandated under the Data Privacy Act of 2012.
Noted by: Conforme:

ENGR. HARVEY C. SERAJOSEPH

__________________________
Company Representative
(Signature over Printed Name)
Date: POLLUTION CONTROL OFFICER/
Position: MECHANICAL ENGINEER
CASTILLO KATHLEEN KAYE
______________________ MATEO M. CASTILLO
______________________
Department: OPERATIONS
Name of Student Name of Parent/Guardian
Contact Number: 0917-125-8415
(Signature over Printed Name) (Signature over Printed Name)
Email Address: harveyserajoseph12@gmail.com Date: Date: