INTERNSHIP CONTRACT AGREEMENT

-is between the Student and the Department of Education-

This Internship Agreement ("Agreement") is entered into this

(“Effective Date”) by and between –
ANGELO DOLDOLEA, a student of the Agusan del Sur State
College of Agriculture and Technology (ASSCAT), of legal age, with
address at Purok 7, Hubang San Francisco Agusan del Sur, hereinafter
referred to as “Intern,”
-and-
DEPARTMENT OF EDUCATION (Datu Lipus Makapandong
National High School) a duly registered entity, institution, or
establishment in the Philippines, with address at Rosario, Agusan del
Sur, represented by its School Principal, MARIA MAGDALINA Q.
SENTONES, hereinafter referred to as “Host Training Establishment”
or “HTE,”
– collectively referred to as “Parties.”

WITNESSETH:

The Parties to this Agreement hereby agree that:

I. General Provisions
1. The Intern shall not be considered as an employee of the HTE for the duration of the internship.
2. The Intern shall not be paid for any services that he or she undertakes at the HTE pursuant the
internship.
3. The HTE and the Intern shall abide by all relevant laws, rules, and regulations, including those
issued by the CHED governing student internships.

II. Obligations of the Intern

The Intern agrees to:
1. Report for internship at the HTE, as follows:
a. Internship Period: October to November
b. Location: Rosario, Agusan del Sur
c. Average number of hours per week: 40 hours per week
d. Schedule:
i. Days: Mondays to Fridays
 ii. Hours: 8:00 a.m. to 5:00 p.m., inclusive of one-hour lunch break;
2. Perform tasks and activities indicated in the Internship Plan (Annex “A”);
3. Adhere to the existing rules and regulations of the HTE, including the proper use of tools,
instruments, machines, and equipment;
4. Submit a journal of internship as required by HTE;
5. Maintain confidentiality, when and where appropriate, during and after the internship period of
all the data, business or trade secrets, where such information is not within the public domain
and is indicated or understood to be confidential; and
6. Comply with the provisions of this Agreement and abide by all relevant laws, policies, rules,
and regulations, including those of the Commission on Higher Education (CHED), the
ASSCAT, and the HTE.

III. Obligations of the HTE

The HTE agrees to:
1. Implement the Internship Plan (Annex “A”) in partnership with the ASSCAT;
2. Orient the Intern on its existing rules and regulations;
3. Encourage the Intern to develop his or her personality and professionalism, and to the extent
possible, protect the Intern from physical or moral danger;
4. Shall not place the Intern in internship venues which degrade, debase, or demean the intrinsic
worth and dignity of the Intern as a human being;
7. Issue a Certificate of Completion for the Intern not later than two weeks after the completion
of internship; and
8. Comply with the provisions of this Agreement and abide by all relevant laws, policies, rules,
and regulations, including those issued by the Commission on Higher Education (CHED).

IV. Confidentiality and Data Privacy

1. All terms and conditions of this Agreement, any materials provided during the term of the
Agreement, and all personal information of the Parties acquired in the implementation of the
Agreement must be kept confidential by both Parties unless the disclosure is required pursuant
to law or any court order or process.
2. Disclosing or using information for any purpose beyond the scope of this Agreement or beyond
the exceptions set forth above is expressly forbidden without the prior consent of the Parties
concerned.
3. Both Parties agree shall abide by the laws, rules, and regulations on data privacy.
V. Intellectual Property of the HTE
The Intern agrees that any intellectual property provided to him or her by the HTE will remain the sole
property of the HTE, including, but not limited to, copyrights, patents, trade secret rights, and other
intellectual property rights associated with any ideas, concepts, techniques, inventions, processes, works
of authorship, confidential information, or trade secrets.
VI. Effectivity and Termination
1. This Agreement shall be effective from the date of the signing of this Agreement, S.Y. 2023
until S.Y. 2025.
2. This Agreement may be terminated earlier, as follows:
a. In the event of the Intern’s breach of this Agreement or misconduct in the HTE’s
premises, the HTE may terminate this Agreement immediately by providing a written
notice to the Intern citing the reason for termination, copy furnished the ASSCAT; or
b. At any given time by either party by providing a written notice to the other party thirty
(30) days prior to the intended date of termination, copy furnished the ASSCAT.
3. Upon the termination of this Agreement, the Intern shall return all the HTE’s materials,
products, or any other content as soon as possible, and not beyond sixty (60) days.

VII. Miscellaneous Provisions

1. Liability. – Each Party shall assume sole responsibility for any damage or injury arising from
its own intentional misconduct or fraud, willful violation of the law, or gross negligence.
2. Grievance Machinery. – In case of any grievance or complaint between the HTE and the Intern
arising from the implementation of the internship program, the HTE or the Intern shall
immediately elevate or submit said grievance or complaint before the Grievance Committee of
the ASSCAT.
3. Warranties. – Both Parties warrant that: (a) as of the Effective Date, they have the power and
authority to enter into this Agreement and to perform their obligations under it, and to grant to
each other the rights provided under this Agreement; and (b) by entering into this Agreement,
they do not violate or infringe upon the rights of any third party or violate any other agreement
between the Parties, individually, and any other person, organization, or business or any law or
governmental regulation.
4. Construction. – This Agreement shall be governed by and construed in accordance with the
laws of the Philippines.
5. Separability. – If any provision of this Agreement is found to be void and unenforceable by a
court of competent jurisdiction, the remaining provisions will remain in force in accordance
with the Parties’ intention.
6. This Agreement contains the entire agreement and understanding between the Parties to it with
respect to its subject matter, and supersedes all prior agreements, understandings, inducements,
and conditions, express or implied, oral or written, of any nature whatsoever with respect to its
subject matter. The express terms of the Agreement control and supersede any course of
performance or usage of the trade inconsistent with any of its terms.
The Parties hereby agree to the terms and conditions set forth in this Agreement and such is
demonstrated by their signatures below:

INTERN: DEPARTMENT OF EDUCATION:

ANGELO DOLDOLEA MARIA MAGDALINA Q. SENTONES

Name and Signature over Printed Name Name of Representative and

Signature over Printed Name
Position: School Principal
Date: _____________________________ Date: _____________________________
 ACKNOWLEDGMENT

Republic of the Philippines )

_____________________________ ) s.s.

BEFORE ME, a Notary Public in and for ______________________, personally

appeared the following persons, who have showed to me competent evidence of their respective
identities bearing the following information –

GOVERNMENT- DATE PLACE

NAME
ISSUED I.D. NO. ISSUED ISSUED

MARIA MAGDALINA Q.
SENTONES

ANGELO DOLDOLEA

– known to me to be the same persons who executed the foregoing instrument and acknowledged to me
that the same is their own and free voluntary act and deed and/or of the agency/entity they represent.

I further acknowledge that this instrument, consisting of _____ pages including this page wherein the
acknowledgement is written, have been signed by the parties and their witnesses on each and every
page.

IN WITNESS WHEREOF, I hereunto set my hand this ______ day of ___________, in

_____________________, Philippines.

Notary Public
My Commission expires on __________

Doc. No.
Page No.
Book No.
Series of 2023.
 Annex A
INTERNSHIP PLAN

I. INTRODUCTION
During the internship program, the student interns are assigned to different areas and
venues, while in the Host Training Establishments (HTEs), the student interns are given actual
work experience in various departments that may be determined and mutually agreed upon by
the school, HTE and the student intern.

II. GOALS/OBJECTIVES:
The exposure to the different work situations is provided to enable the student intern
experience and observe the practical application of theories learned in the school.
At the end of the internship program, the student should be able to:
1. Apply relevant knowledge and skills acquired from formal education to actual work
setting.
2. Enhance the knowledge and skill acquired in formal education of student interns through
employer-based training.
3. Develop life skills including those relevant to the values of professionalism and work
appreciation.
4. Acquire soft skills necessary to address the demand of the employers such as
communication skills, interpersonal skills, financial literacy, etc.
5. Acquire a professional work ethic in the course of internship.

Ill. REQUIREMENTS OF THE PROGRAM:

A. List of documents for the student internship as stipulated in the CMO 104, s.2017.

B. Orientation and Briefing

The ASSCAT Student Internship Office, Deans, Program Chairperson, OSA, and HTE
representative shall conduct the orientation and pre-internship seminars. The following shall
be thoroughly discussed:
1. Training Expectations
2. Guidelines
3. Rules & Regulations
4. Course Requirements
5. Inputs from HTE

C. Internship Contract
 An internship Contract is signed by the student intern, the ASSCAT and the Host
Training Establishment (HTE). This agreement identifies the student intern's tasks and some
policies regarding the program.

D. Performance and Rating Form

The culmination of the internship program is the evaluation of the student intern
performance. The evaluation should contain the following:

Name of Student Intern: ANGELO DOLDOLEA

Name of the HTE and address: Datu Lipus Makapandong National High School,
Rosario, Agusan del Sur
Internship Period: Start: End:

Department/Tasks Period Student Performance/Outcomes Rating Remarks

Orientation/Class 1 st • Familiarized with the structural
Observation Week organization and procedures of the
HTE.
• Be oriented on the school protocols.
• Identified strategies of teaching and
assessment tools employed by the
cooperating teacher.
Observation of 2 nd • Identified strategies of teaching and
Classes/Lesson Week assessment tools employed by the
Planning/ Attending cooperating teacher.
School Activities • Crafted a lesson plan.
• Attended and participated school
activities.
Lesson Planning/ 3 rd • Crafted a lesson plan.
Preparation of Week • Developed instructional materials.
IMs/Class Teaching/ • Conducted class teaching applying
Attending School varied teaching strategies and
Activities assessment tools.
• Attended and participated school
activities.
Lesson Planning/ 4 th • Crafted a lesson plan.
Preparation of Week • Developed instructional materials.
IMs/Class Teaching/ • Conducted class teaching.
Attending School • Attended and participated school
Activities activities.
Lesson Planning/ 5 th • Crafted a lesson plan.
Preparation of Week • Developed instructional materials.
IMs/Class Teaching/ • Attended and participated school
Attending School activities.
Activities/ Grand •
Demo Teaching as to • Conducted class teaching applying
Schedule varied teaching strategies and
assessment tools.
 • Attended and participated school
activities.
• Performed grand demonstration
teaching.
Lesson Planning/ 6 th • Crafted a lesson plan.
Preparation of Week • Developed instructional materials.
IMs/Class • Conducted class teaching applying
Teaching/Attending varied teaching strategies and
School Activities/ assessment tools.
Grand Demo • Attended and participated school
Teaching as to activities.
Schedule • Performed grand demonstration
teaching.
Lesson Planning/ 7 th • Crafted a lesson plan.
Preparation of Week • Developed instructional materials.
IMs/Class Teaching/ • Conducted class teaching applying
Attending School varied teaching strategies and
Activities / Grand assessment tools.
Demo Teaching as to • Attended and participated school
Schedule activities.
• Performed grand demonstration
teaching.
Lesson Planning/ 8 th • Crafted a lesson plan.
Preparation of Week • Developed instructional materials.
IMs/Class Teaching/ • Conducted class teaching applying
Attending School varied teaching strategies and
Activities / Grand assessment tools.
Demo Teaching as to • Attended and participated school
Schedule activities.
• Performed grand demonstration
teaching.

E. STUDENT INTERNSHIP HEALTH AND SAFETY MEASURES

For Laboratory Works

Risk Safety Measures

Possible exposure to hazardous chemical. Proper handling of chemical and biological
specimen and wastes.
Injury due to broken laboratory glassware Proper training and handling of laboratory
and equipment. glassware and equipment.

For Classroom Works/ Office Works

Risk Safety Measures

Electrocution Observe precautionary measures.

Never attempt to repair damaged electrical
wirings.
Violence and Harassment Employ positive discipline.
For Open Field Works

Risk Safety Measures

Animal bites Wear protective gear.

Always carry first aid kit.

Electrocution Observe precautionary measures.

Never attempt to repair damaged electrical
wirings.

Slips, trips, and fall Use proper gear and comfortable clothing.
Follow designated trails and signages.

Injuries due to unguarded moving Follow road signs, warnings and signages
machineries and vehicles

F. CERTIFICATION

A certification with the logo issued by the HTE is issued to student intern after the
completion of the designated number of hours. The certification bears the seal, signed by the
HTE's authorized representative.