Immersion-Forms-2023.docx for work immersion

forms

1. Republic of the Philippines
DEPARTMENT OF EDUCATION
Region XI
DIVISION OF DAVAO DEL NORTE
TIN 000-863-958-119
DAVNOR SHF-1
STUDENT ATTENDANCE
Name of Student: _____________________________________ School: __________________ Municipality: _______________________
Agency/ Department Assigned: _________________________________ School Principal: ______________________________________
Immersion Program Coordinator: _______________________________ Contact Number: _____________________________________
Date Time IN Signature Time OUT Signature Attested by:
(Immediate
Supervisor)
Submitted by: Checked by : Attested: Approved:

2. MARIVER B. SEMBLANTE OLIVER P. PONSADES EdD
Student Coordinator Immediate Supervisor
School Head
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region XI
DIVISION OF DAVAO DEL NORTE
TIN 000-863-958-119
DAVNOR SHF-2
WORK SCHEDULE
Name of Student: _____________________________________ School: __________________ Municipality: ______________________
Agency/ Department Assigned: _________________________________ School Principal: ______________________________________
Immersion Program Coordinator: _______________________________ Contact Number: _____________________________________
Date Work
Engagement
Function Accomplishment Signature Attested by:
(Immediate
Supervisor)

3. Submitted by: Checked by: Attested: Approved:
MARIVER B. SEMBLANTE OLIVER P. PONSADES EdD
Student Coordinator Immediate Supervisor
School Head
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region XI
DIVISION OF DAVAO DEL NORTE
TIN 000-863-958-119
MEMORANDUM OF UNDERSTANDING (MOU)
This Memorandum of Understanding has been crafted to establish the common understanding of the roles, functions
and responsibilities of the school, parents and students on the Immersion Program of the Senior High School. The following
defines the said specificities:
Roles, Functions and Responsibilities of the School:
1.Sets the pre-deployment Orientation of the students;
2.Looks for industry partners that fit to the track of the students are enrolled;
3.Spearheads the Memorandum of Agreement with the Industry partner;
4.Monitors the progress of the students while before, during and after the immersion of the students;
5.Reports to the school authorities any untoward behavior or incident that occurred in the immersion place;
6.Ensures safety of the students in coordination with the parents and other school authorities;

4. 7.Rates the performance of the students according to the competencies.
Roles, Functions and Responsibilities of the Student:
1.Attends to the Immersion sessions (80 hours);
2.Reports to the department/agency on time;
3. Records honestly his/ her accomplishment;
4.Behaves according to the standards of the agency/department;
5.Shows respect and courtesy in dealing with the work environment and the clients dealing with;
6.Manifests honesty and sincerity;
7.Attends to all orientations and seminars set by the school and department/ agency where he/she is assigned;
8.Attends the culmination of the Immersion program with the parents;
9.Submits portfolio as a proof of his/ her accomplishment.
10.Faces consequences when violations of the school/ industry rules are proven;
11.Submits to Medical Certificate as a pre-requisite of work immersion.
Roles, Functions of the Parent:
1.Attends to the General Orientation with the students;
2.Signs the Memorandum of Understanding;
3.Attends to the Culmination of the Immersion Program
4.Reminds always his/her student of his/her safety and welfare;
5.Supports his/her student in securing the Medical Certificate
CONFORMED:

5. ___________________________ ______________________________ MARIVER B. SEMBLANTE OLIVER P. PONSADES
EdD
Student Parent Immersion Coordinator Principal
ATTESTED:
DR. EDUARD C. AMOGUIS JANETTE G. VELOSO, CESO VI
CHIEF, CID Assistant Schools Division Superintendent
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region XI
DIVISION OF DAVAO DEL NORTE
TIN 000-863-958-119
DAVNOR SHF-3
INVENTORY OF IMMERSION PARTNERSHIP
Name of Student: _____________________________________ School: __________________ Municipality: _______________________

6. Agency/ Department Assigned: _________________________________ School Principal: ______________________________________
Immersion Program Coordinator: _______________________________ Contact Number: _____________________________________
Track Strand Industry Partners With Moa / without
Moa
Remarks