STATEMENT OF CONFIDENTIALITY

That I, _____________________________________ of legal age, Filipino, a student of (NAME

OF SCHOOL), that on this______ day of ________20__, as a condition in the conduct of
the On-the-Job Training Program with Schools Division Office of Malabon City
(SDO-Malabon) I hereby state the following:

1. That I acknowledge and understand while in the course of my on-the-job

training, I may be allowed, or been able to receive, access, become aware
and/or be in possession of Confidential Information of SDO-Malabon and/or its
stakeholders. I agree that such access or possession of Confidential Information
is allowed exclusively for the limited purpose of performing my duties and
functions as trainee. Thus, I agree and oblige myself not to divulge or use such
Confidential Information, in any manner, outside of my duties and functions. In
case of violation or threatened violation of this undertaking, I agree that SDO-
Malabon may proceed on any legal action it may deem necessary against me
and/or my violation without prejudice to other remedies under the
Memorandum of Agreement and applicable laws;

“Confidential Information” shall mean information hereby regarded

as such, including information of SDO-Malabon:

a. That relating to past, present or future research, development of

professional affairs, and any proprietary information, materials or
methodologies;
b. That of documents or records known by reason of official capacity
which are deemed confidential in relation to the performance of its
official function, inquiry and/or investigation in the exercise of this
Office administrative, regulatory or quasi-judicial power;
c. That matters considered confidential under its banking and/or
financial relations, laws, rules and regulations;
d. That of classified, privileged and top secret in nature;
e. That protected under Data Privacy Act of 2012 or any personal
information not of public concern or interest;
f. That those specified under Executive Order No. 2, s. 2016 and other
related issuances thereof.

2. That I undertakes to maintain and secure the maintenance of these

Confidential Information at all times and to keep safe and protect said
information of SDO-Malabon and its stakeholders against unauthorized access
and not at any time, whether during training or thereafter, to use, authorize,
permit the use of any or to disclose, exploit, copy and/or modify the said
Confidential Information, or authorize or permit any third party to do the same,
without appropriate consent or authority to any data subject and SDO-Malabon
duly authorized personnel allowed by law;

3. That I herein agreed that any information or data that is collaterally

needed to be saved, collected, and stored using my personal memory storage
drive1/gadget2/account3 or kept under my control, during the conduct of the
said training shall be surrendered and given immediately to the officer and/or
authorized personnel of the unit/section/division where I am assigned, and
thereafter all said information shall be deleted entirely from the said personal
memory storage drive/gadget/account;

1
Flash drive, portable hard drive, compact disk, diskette, memory card, and other analogous things that
used primarily for data storage.
2
Computer laptop, cellular phone, smart phone, notebook computer, tablet computer and other
analogous things that store data/information.
3
Social media account, electronic mail account, cloud account
 4. That for educational purposes only and as part of the requirement of the
my degree as to this on-the-job training is undertaken, I fully understand that
any data, modes of verification documents and/or information necessary to be
secured shall be fully known to and authorized in writing by the
unit/section/division head, where I am designated, and secure the written
consent of the data subject whose information is collected and be used thereof;

5. That I shall not try to access any Confidential Information not within the
scope of my duties nor misuse, mishandle, delete or destruct any Confidential
Information which I may collaterally got hold of;

6. That upon termination, for any cause, or completion of this training, I

undertake to turn over to SDO-Malabon, all its property including equipment,
correspondence, documents, records, data software, disks and other
information-storing medium, specifications, models and all copies, summaries
notes and reproductions thereof, and any other property belonging to or relating
to the operation of SDO-Malabon which are in my possession or under my
control;

I certify and acknowledge that I have carefully read all of the provisions of this
document and that I understand and willfully and faithfully comply with such
provisions.

__________________________________________________
Signature over Printed Name
Date signed: ______________

Certified by:

JOSE M. RAPSING, LPT, Ph. D PROF. MARIA LUISA V. TONGCO

Dean, College of Teacher Education Program Chair, College of Teacher Education

Noted by:

DR. JOSEFINA M. PABLO _______________________________________

Chief Education Supervisor School Principal
Curriculum Implementation Division