CONSENT FORM

(Affidavit of Consent)

WE, _____________________________ and ___________________________, both

of
(Student-Trainee) (Parent/Guardian)
legal ages and with address at ____________________________________, under oath, state
that:

We express our consent to allow the said student-trainee to undergo on-the-job training/
practicum for a minimum of 300 hours beginning on ___________________ until
________________________ at ________________________________ with office address at
_________________________________________________in partial fulfillment of the
requirements in __________________________________.

We are aware that the immediate superior of the said company will take all the necessary
precautions to keep the student-trainees safe. On-the-Job Training supervisors will also be there
to periodically monitor the performance and safety of the student-trainees.

We execute this Affidavit of Consent, freely and voluntarily, to attest to the truth and
veracity of the foregoing, realizing the benefits that the student-trainee shall obtain from the said
on-the-job training/practicum.

In witness whereof, we have hereunto set our hands this ________________, 2023 in
Catanauan, Quezon.

____________________________ _____________________________

Name & Signature of Student-Trainee Name & Signature of Parent/Guardian

Republic of the Philippines)

Catanauan, Quezon………)

Subscribed and sworn to before me, this __________________, 2023 in Catanauan,

Quezon, Philippines, by affiants who exhibited the following competent proofs of their identities:

Name Proof of Identity

Doc. No.______;
Page No. _____;
Book No. _____;
Series of 2023.