TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY

(TESDA) REGION I
MAXIMA
TECHNICAL AND SKILLS TRAINING INSTITUTE INC.
TESDAACCREDITED TRAINING AND ASSESSMENT CENTER
#20 PEREZ BOULEVARD DAGUPAN CITY

ON THE JOB TRAINING /IMMERSION

PROGRAM FOR

COMPUTER SYSTEM
SERVICING NC II A.Y. 2022

PERTINENT PAPERS OF

OLIVER S. LACSON
TRAINEE

BRENDA H. MARTINEZ
TRAINER
 TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY
(TESDA) REGION I
MAXIMA
TECHNICAL AND SKILLS TRAINING INSTITUTE INC.
TESDAACCREDITED TRAINING AND ASSESSMENT CENTER
#20 PEREZ BOULEVARD DAGUPAN CITY

APPLICATION FOR OJT/IMMERSION

STUDENT NO: CSS-21241

Please print legibly and answers all entries correctly.

NAME:
OLIVER S. LACSON
AGE: 20 YEARS OLD AGE: 20 YEARS OLD
GENDER: MALE GENDER: MALE
HEIGHT: 5’8 HEIGHT: 5’8
BIRTHDATE: JANUARY 12, 2002 BIRTHDATE: JANUARY 12, 2002
BLOOD TYPE: B- BLOOD TYPE: B-
RELIGION: ROMAN CATHOLIC RELIGION: ROMAN CATHOLIC
CURRENT ADDRESS: 21 SAN ISIDRO SUR, BINMALEY, PANGASINAN
HOME ADDRESS: 21 SAN ISIDRO SUR, BINMALEY, PANGASINAN
COURSE: COMPUTER SYSTEM SERVICING
I hereby that the information is true and correct to the best of my knowledge and belief.

_______________________________________
TRAINEE
SIGNATURE OVER PRINTED NAME

Res. Cert. ___________________

THUMB MARK LEFT THUMB MARK RIGHT Issued at ___________________
Issued on ___________________

I hereby certify that the same student gave the above information voluntarily with the attached photo and thumb mark.

BRENDA H. MARTINEZ SUSANA ELORIN TANDOC

TRAINER, CSS NC II SCHOOL HEAD
 TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY
(TESDA) REGION I
MAXIMA
TECHNICAL AND SKILLS TRAINING INSTITUTE INC.
TESDAACCREDITED TRAINING AND ASSESSMENT CENTER
#20 PEREZ BOULEVARD DAGUPAN CITY

MEMORANDUM OF AGREEMENT

KNOW ALL MEN BY THESE PRESENTS:

This memorandum of agreement is made and entered into by

and between the MAGIC SERVICE CENTER with postal address at
Perez Boulevard, Dagupan City, Pangasinan
Represented by Manager, RACHELLE T. BRAVO referred to as the
FIRM/INDUSTRY;

AND

The MAXIMA TECHNICAL AND SKILLS TRAINING INSTITUTE

INC., with postal address at #20 Perez Boulevard, Dagupan City,
Pangasinan represented by SUSAN ELLORIN TANDOC, herein after
referred to as the School Head

WITNESSETH

WHEREAS, the Company/ Industry has instituted On-the–Job

Training Program (OJT) offering its facilities and personnel to develop a pool
from to train and recruit the needed skilled workers to fill in its future
Manpower requirements and to provide assistance in the manpower
development efforts of the region.
WHEREAS, the School/ Institution is offering Basic, Common and
Core Competencies training, program in Dagupan City, Pangasinan, where
in trainees required undergoing such training to gain adequate exposure to
Actual work situations thus augments their school training program.

NOW, THEREFORE, for and in consideration of the foregoing

premises, the Company/ Industry and the school do hereby agree and
stipulate the following.
 TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY
(TESDA) REGION I
MAXIMA
TECHNICAL AND SKILLS TRAINING INSTITUTE INC.
TESDAACCREDITED TRAINING AND ASSESSMENT CENTER
#20 PEREZ BOULEVARD DAGUPAN CITY

A. THE INDUSTRY/COMPANY SHALL:

 Accept the trainees recommended by the school to undergo On- Job Training
Program.
 Assign personnel to take charge, train and supervise the trainees
 Accomplish the require forms in connection with said training.
 Adopt and enforce rules that will govern the conduct of the programs to be
made known. To the trainees before starting of training.
B. THE SCHOOL SHALL:
 Select/ Recommend trainees for On- the-Job Training Program (OJT).
 Designate a coordinator who will coordinate with the firm on the various
Training activities.
 Submit to the Industry/Company the required documents.

C. UNDER THE MEMORANDUM OF AGREEMENT, THE FOLLOWING TERMS

AND CONDITIONS ARE LIKEWISE INCLUDED:
 It is understood that there will be no labor- management relationship between
the INDUSTRY / COMPANY and the trainees of the school.
 The trainees will be personally responsible for any and all liabilities for damage
to property training; and
 The trainees shall abide by the Company/ Industry rules and regulations and
comply with those imposed for the program, otherwise they shall be excluded.

D. DURATION:
This Agreement shall take effect immediately upon signing hereof and
shall continue thereafter, provided
However, that any provision of this agreement maybe amended by
written consent of both parties and provided further that the agreement upon
written notice.

IN WITNESS WHEREOF, the parties here to have signed on this 20 th

day of August 2020 in Dagupan City, Pangasinan.

Company/Industry Partner: Training Center:

RACHELLE T. BRAVO SUSANA ELLORIN TANDOC

Manager School Head
 TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY
(TESDA) REGION I
MAXIMA
TECHNICAL AND SKILLS TRAINING INSTITUTE INC.
TESDAACCREDITED TRAINING AND ASSESSMENT CENTER
#20 PEREZ BOULEVARD DAGUPAN CITY

Signed in the Presence of:

CARLITO P. YU BRENDA H. MARTINEZ

OJT Coordinator Trainer

With our conformity:

JOAQUIN F. GOMEZ JUANITO V. COSTALES

Co-Trainee Co-Trainee
 TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY
(TESDA) REGION I
MAXIMA
TECHNICAL AND SKILLS TRAINING INSTITUTE INC.
TESDAACCREDITED TRAINING AND ASSESSMENT CENTER
#20 PEREZ BOULEVARD DAGUPAN CITY

OJT PROGRAM
EVALUATION SHEET
NAME: OLIVER S. LACSON
SECTOR: ELECTRONICS
COURSE: CSS NC II
PERIOD OF TRAINING:
DATE BEGAN SEPTEMBER 7, 2020 DATE FINISHED: NOVEMBER 25,
2020
NAME OF COMPANY/INDUSTRY:
MAGIC SERVICE CENTER
ADDRESS OF COMPANY/INDUSTRY:
PEREZ BOULEVARD, DAGUPAN CITY, PANGASINAN

EVALUATION CRITERIA RATING

TECHNICAL KNOWLEDGE GAINED (35%) 35%

MANIPULATIVE SKILLS ACQUIRED (35%) 35%

HUMAN RELATIONSHIP AND PERSONAL TRAITS (30%) 28%

TOTAL POINTS EARNED: 98%

RACHELLE T. BRAVO NOVEMBER 25, 2020

Manager Date Accomplished