Republic of the Philippines

POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

Sto. Tomas Branch

OJT STUDENT PROFILE

Name: Kristofer Melitante

Nickname: Kristoff
Age: 21 Gender: Male
Address: San Fernando Malvar
Contact Information:
Landline: Mobile: 09107478160
Email: kenjkristofer@gmail.com

Contact Person in case of emergency: Princess Melitante

Relationship: Sister Contact Number: 09463846847

Educational Background: PUP Sto. Tomas Branch

Special Trainings/Certifications
Company Name: Citizen Machinery Phil. Inc.
Company Address: FPIP, Lot No. 29 Barangay Ulango , Tanauan City,
Batangas 4232

Division/Department: PPCD Purchasing Group/ Warehouse Assembly

Training Supervisor: Alan Polinga
Position: Purchasing Supervisor

Poblacion 2, Sto. Tomas Batangas Phone: 043-7783508

THE COUNTRYS 1ST POLYTECHNIC U
 Republic of the Philippines
POLYTECHNIC UNIVERSITY OF THE PHILIPPINES
Sto. Tomas Branch

WAIVER

KNOW ALL MEN BY THESE PRESENTS:

I, Min Fong Hsu, Filipino, 20 years old, single, with residence at 554 San Felix,
Sto.Tomas, Batangas and presently enrolled at the Polytechnic University of the
Philippines Sto. Tomas Branch, Sto. Tomas, Batangas, hereby voluntarily renounce
and waive, with the conformity of my guardian and all claims that I have against the
said Polytechnic University of the Philippines, and/or its officials, arising from any
cause/s that may occur in connection with my Practicum (On-the-Job Training) for 350
hours at the Citizen Machineries Phil. Inc.

IN WITNESS HEREOF, I hereby affix my signature this __________ day of

_______________, 20___, in the City/Municipality of ____________________.

WITH MY CONSENT AND CONFORMITY:

CTC No.
Issued at
On

SUBSCRIBED AND SWORN TO before me this ____ day of _____________,

20___. Affiant exhibited to me his/her Community Tax Certificate No.
__________________ issued at _____________________on
____________________.
Doc. No. _________ Page No.________
Book No. ________ Series of 20__

Poblacion 2, Sto. Tomas Batangas Phone: 043-7783508

THE COUNTRYS 1ST POLYTECHNIC U