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CONSENT FORM

We, ELIZALDE D. MIEN and MARY GRACE N. MIEN, hereby execute this Consent Form
allowing my son/daughter GRACELLIE N. MIEN to undergo on-the-job training/ internship for a
minimum of ________ hours beginning 7:30 A.M until 5:00 P.M at RAGAY CENTRAL
SCHOOL with office address at POB. ILAOD, RAGAY, CAMARINES SUR in partial fulfillment
of the requirement for the Bachelor of Elementary Education.

We are aware that the immediate superior within the company will take all the necessary
precautions to keep the students safe. The OJT and Quality Assurance Coordinators will also
be there to periodically monitor the performance and safety of the students.

We execute this Consent Form in accordance with our free will, realizing the benefits
that the student intern shall obtain from the said on-the-job training/ internship program.

GRACELLIE N. MIEN MARY GRACE N. MIEN


(Name and Signature of (Name and Signature of
Student Intern) Parent/ Guardian)

REPUBLIC OF THE PHILIPPINES )


CITY OF ____________________ ) S.S.

Subscribed and sworn to before me, this ____________________________________


at _________________________________________, Philippines, affiants exhibiting valid
proofs of their identity as follows:

Name ID No. Issued at/on

________________________________ _______________ ____________________

______________________________ ________________ ____________________

They acknowledged to me that the foregoing Consent Form was executed in accordance
with their own free will.

NOTARY PUBLIC

Doc. No. _____;


Page No. _____;
Book No. ____;
Series of _____.

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