COL

LEGE OF HOSPITALITY & INSTITUTIONAL MANAGEMENT

Quezon City

SUPERVISED WORK EXPERIENCE PROGRAM

APPLICATION FORM

Date Filed:
January 15, 2024

Name: ___ Samera Giovanni Ivan Arado_______________

Last Name First Name Middle Name

Course: Bachelor of Science in International Tourism Management Major in Travel and

Tours Operation________________________________________________________

Complete Address: Blk 52 L7 P8 Mabilis St. Brgy. San Pedro, City of San Jose del
Monte, Bulacan______________________________________________________

GSuite/OLFU Email Address: gasamera0051qc@student.fatima.edu.ph

Facebook Account : Giovanni Samera

Telephone Number : ___________________________
Cell Phone Number/s:
0949-478-4891
0961-061-5379

We have read, studied and understood the contents of the Supervised Work
Experience Program Requirements, Policies and Procedures of Our Lady of Fatima
University, College of Hospitality & Institutional Management during the
Practicum Orientation Seminar conducted by the SWEP Office and will abide by
the school policies therein printed.

GIOVANNI IVAN A. SAMERA ____ ROLAND S. SAMERA___

Signature Over Printed Name Signature Over Printed Name
Student Parent/Guardian
0916-376-0677 Contact Number

Note: Submit this paper to your SWEP Coordinator before starting your training,
together with Student’s Evaluation of Grades and Photocopy of Registration Card.

Attached herewith is the SCANNED/SCREEN SHOT COPY of IDENTIFICATION

CARD of the parent/guardian who signed in the waiver.