COLLEGE OF NURSING

Santiago City, Isabela, Philippines

Tel/Fax: (078) 682-8256 Local 123
www.northeasterncollege.edu.ph

INTERNSHIP CONTRACT/AGREEMENT

KNOW ALL MEN BY THESE PRESENTS:

This INTERNSHIP CONTRACT/AGREEMENT made and entered into in Santiago
City, Philippines, this ______ of ________, 20__ by and between:
FLORES MEMORIAL MEDICAL CENTER, with office address at Abauag St.,
Villasis, Santiago City, a duly authorized teaching and training agency of the Department of
Health, represented by TERESITA F. COSENG, MMHoA (Hospital Administrator); and
NORTHEASTERN COLLEGE INC., School/College/University with business and
postal address at Maharlika Road, Villasis, Santiago City, Isabela, 3311, a duly recognized
Institution by the Commission on Higher Education represented by its Department Dean,
JUDITH B. LUTRANIA, RN, LPT, MAN, hereinafter referred to as the Higher Education
Institution (HEI) ;
-and-

KCEEY ESTHER O. CRUZ, Filipino, of legal age, and with residence at KASOY
STREET CALAOCAN SANTIAGO CITY ISABELA.
Individually and collectively, the “Party/ies”

WITNESSETH:
WHEREAS, the HEI aims to enrich its degree programs to respond to the need of the
industry, to promote mutually supportive academe industry collaboration and linkage, to
strengthen the career guidance of its students, and to provide its students with opportunities to
apply relevant knowledge and skills require from formal education to the actual setting.
WHEREAS, the HEI aims to where it can customize the process of technical training
through employer-driven Internship Plans, to select well-equipped beneficiaries, and have an
opportunity to contribute to society through corporate social responsibility.
WHEREAS, the SI aims to enhance the knowledge and skill acquired from formal
education through employer-based training, to become more responsive to the future demands of
the labor market, to develop life skills and values relevant to professionalism and work
appreciation, and to acquire professional work ethic in the course of the internship.

NOW, THEREFORE, based on the above-stated premises, the Parties have mutually
agreed to enter into the following conditions:
1. STUDENT INTERNSHIP PROGRAM. The HEI’s Student Intern Program shall consist
of the following terms:
 1.1 The program shall expose the SI to training under the actual work setting at HTE for a
minimum of ______ hours.
1.2 The Program shall begin on _________________ and end on
____________________. The HEI, HTE, and SI may mutually agree in writing to an
extension of such period.
1.3 The schedule shall be agreed upon between the SI and HTE, provided that the daily
practicum schedule shall not be longer than eight (8) hours. For the purposes of this
contract. The SI’s schedule shall be __________________________.
1.4 The SI shall be assigned and given actual experience in various areas/department of
the HTE except in areas with COVID-19-diagnosed and suspected patients.
2: OBLIGATIONS AND RESPONSIBILITIES OF TE HEI. The HEI shall:
2.1 assume responsibility over the SI during his/her internship;
2.2 Select the HTE and acceptability of the internship plan and internship venues in order
to protect the SI’s interest;
2.3 Implement, in collaboration with the HTE, the internship plan for the SI specifying
the specific goals and objectives to be attained. The internship plan is attached herein;
2.4 Ensure that the SI will acquire actual and relevant competencies in each learning area,
assignment, and schedule of activities;
2.5 Provide appropriate insurance coverage;
2.6 Assign a Student Internship Coordinator for the program; and
2.7 Conduct pre-internship orientation to the SI, as a prerequisite to deployment to the
HTE, on work environment issues, including but not limited to proper work ethics and laws
against sexual harassment;
2.8 safeguard the SI from harassment, exploitation, deplorable training conditions, and
such other conditions that contravene or defeat the purpose of the program;
2.9 consult and assist the SI in resolving problems or issues encountered in th HTE;
2.10 take appropriate action on any complaint against the SI in accordance with the HEIs
policies, rules and regulations;
2.11 Conduct visit and inspection of the HTE to ensure the safety of the SI;
2.12 Monitor and evaluate performance of the SI jointly based on the agreed internship
plan
2.13 Conduct an evaluation of the HTE to gauge the feedback mechanism.
3: Reporting
3.1 Submit to CHED through the CHED Regional Office (CHEDRO) the following
documents:
3.2 Annual report per school year on implementation of SIPP on the number of student
interns per program, their issues and concerns and actions to be taken to address the issues
among others to be signed by school head or authorized representative such as deans of
concerned program and/or registrar;
3.2 Copy of duly notarized MOA; and
3.3 List of partner HTEs and student interns duly certified by authorized school official to
have completed internship.
4: Roles and Responsibilities
1. Clinical Instructors
1.1 Inspect the area of the internship before the internship period;
1.2 Prepare the practicum materials;
1.3 Prepare MOA checked by the legal counsel of the HEI and coordinate
with HTEs for signing;
1.4 Take necessary actions in preparing students before deployment and
providing them the guidelines in the performance of their duties
1.5 Coordinate with the Dean or authorized school coordinator for the
purpose of the internship orientation;
 1.6 Monitor and assists SI with their concerns during the period of RLE
duties
1.7 Checked if the SIs requirements have been accomplished; and
1.8 Observed the protocols of the HTE with regard to their protocols on
COVID-19.
2. SIPP COORDINATOR
2.1 Coordinate with the adviser/internship coordinators, department deans,
and administrators for the effective implementation of internship
programs
2.2 Inspect internship sites before the internship period
2.3 Provide pre-internship orientation prior to deployment to internship
venues including among others work ethics and anti-sexual harassment
as pre-requirement
2.4 Monitor and assess student interns if the need arises
2.5 Consult and assist student interns in resolving problems/issues
encountered
2.6 Validate the result of the internship of students per batch feedback/post–
conference based on the submitted accomplishment report, at the end of
the internship period
2.7 Prepare and submit pertinent reports on the implementation of the
Student Internship Program in the Philippines (SIPP) required by the
Commission on Higher Education (CHED)
3. Parent/Guardian
3.1 Attends NC-College of Nursing Orientation and other instance/s where
their presence is required;
3.2 Encourages the student intern to carry out his/her responsibilities
effectively;
3.3 Shares responsibilities for the conduct of the student intern while in the
program;
3.4 Ensures the safety of the student intern while traveling to and from
school and at the HTE;
3.5 Signs the written consent; and
3.6 Co-signs the internship contract and/or agreement to manifest approval
or consent to the internship of their child.
5: PLACE OF ASSIGNMENT
The Student intern shall be assigned to the different areas/departments of the HTE
which are collaborated with the HEI.
6: COMPENSATION AND BENEFITS
Under this section, the following provisions may be included but optional among
others:
1. Allowance: allowance will be provided by their parents/guardians;
2. Duty Meals: SIs will be required to bring their own food/meals during their duty
observing the COVID-19 protocols;
3. Uniform: Clinical uniform will be worn only when inside the hospital. SIs are
required to bring extra clothing to be worn after duty;
4. Insurance: Insurance will be added to the SIs assessment during enrollment
5. Duty Hours: SIs are given 8 hours of duty/day, 2 days /week;

This agreement, as well as its terms and conditions herein, shall be held in strict
confidence and that no portion or part hereof may be reproduced or be revealed to any personnel
or entity other than the signatories herein or their authorized representative;
 IN WITNESS WHEREOF, the Parties has hereunto this agreement on
______________, 20___ at Northeastern College, College of Nursing, Maharlika Road, Villasis
Santiago City, Philippines.

____________________________________ KCEEY ESTHER O. CRUZ

Name and Signature of HTE Representative Name and Signature of Student Intern
Contact Number: _____________________ Student ID No.: 17200105
Contact Number: 09959381107

MARION SITCHON
Name and Signature of Parents/Guardian
Contact Number: 09217524527

________________________________
MARIA REBECCA CORAZON A. MANIPON, RN, MAN
Clinical Coordinator
09270221746

________________________________
JUDITH B. LUTRANIA, RN, LPT, MAN
Dean, College of Nursing
09165135006
 ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES

BEFORE ME, a Notary Public for and in the above jurisdiction, personally appeared the
following:

NAME IDENTIFICATION CARD/ DATE/PLACE NUMBER ISSUED

1. _____________________ _________________ _________________

2. ______________________ _________________ _________________

known to me to be the same persons who executed the foregoing instrument and acknowledged
to me that the same is their own free will and voluntary act and deed.

This instrument consists of five (5) pages including this page wherein this
Acknowledgement is written, and signed by the parties and their instrumental witnesses on each
and every page hereof.

WITNESS MY HAND AND SEAL, this_________ day of ________ , _____ at

______________.

NOTARY PUBLIC
Doc. No. ;
Page No. ;
Book No. ;
Series of 2023.