ANNEX C: Prescribed Template for The List of Task

Grade and
Name of Student
Section
Immersion
School
Site
Strand/
Track
Specialization

Duration
Of Work Immersion

School
Contact
Partnerships
Number
Focal Person

Work
Contact
Immersion
Number
Teacher

LIST OF TASKS/ACTIVITIES
Tasks/ Actual
Competencies Time Allotment Remarks
Activities Schedule
Student shall not be given other activities outside of those previously agreed upon, which are anchored on the stated competencies.

Certified true and correct:

________________________________________ ________________________________________
Student’s Signature Over Printed Name Parent’s Signature Over Printed Name

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Work Immersion Teacher’s Signature Over Printed Name Industry Supervisor’s Signature Over Printed Name