UNIVERSITY OF ST.

LA SALLE
Bacolod City

INTERNSHIP PROGRAM
SUMMER 2018

NAME OF STUDENT :

COURSE/YEAR/SECTION :

SUBJECT CODE (OJT) :

NAME OF COMPANY :

ADDRESS :

DATE STARTED :

DUTY SCHEDULE :

REQUIRED # OF HOURS :

Submit this Booklet (all requirements compiled and soft-bound, with green cover for
CAS, yellow for CBA) to the Internship Coordinator after you have complied with the
required Internship hours and settled any accountability with the company.

Received By: _________________________________ Date: ______________________

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 INTERNSHIP APPLICATION PROCEDURE FOR CAS & CBA

Pre-Deployment Phase (March-April 2018)

INITIAL REQUIREMENTS – 20% of Total Grade

 Attend Orientation and Pre-deployment Seminar

 Choose Internship Site from the List
 Submit the following documents to your preferred site: (2 copies each document)
o Endorsement Letter

Follow the standard format with built-in letterhead

Should be signed by the Internship Coordinator and Department
Chair
 Unique for each department
 Samples are available for downloading (FB-USLS CBA/CAS
INTERNS)
o Application or Cover Letter
o Resume with recent 2x2 photo (corporate attire against a white
background)
o Parental consent

Deployment Phase (April 2018)

 If accepted by the company and once training has started...

o Print out the Internship Booklet and compile in a white long folder. Fill
out Internship Information Sheet and other forms (write neatly or
computerized preferably)
o Submit a long folder (profile folder) to the Internship Coordinator with
the following documents: (Within 1st 5 days of deployment or at the
very latest April 20, 2018)
 Copy of Internship Information Sheet with 2x2 photo and signed
by you and your supervisor
 Copy of the Endorsement Letter received by the company
 Copy of application letter submitted to the company
 Copy of resume submitted to the company
 Parental Waiver (duly signed)
 Oath of Undertaking(duly signed)
 Site Map (Google, computerized)
 Company Profile
 Training Agreement or Contract if any

 If rejected, go back to step 1…

 Submit Monthly Accomplishment Report of the past month’s work every first
Tuesday of the month signed by your supervisor with not less than 200 HOURS
for a 6-unit course and at least 100 HOURS for a 3-unit course one week before.
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Monitoring Phase (starting April 2018)
MIDTERM REQUIREMENTS – 50% of Total Grade

 Submit the following a week before Endterm Exam: (May 7, 2018)

o Reflection Journal/Personal Insights with the following guide questions:
(1 or 2 Questions per page it should be Computerized)

 What did I learn from my Internship experience in terms of knowledge,

skills and attitude?
 In what situations was I able to apply the Expected Lasallian Graduate
Attributes?

 How are these learning helpful in preparing myself for

professional life after college?
 What can I recommend for the improvement of the Internship
Program?

o Pictures at the Job site (at least 2 ) pasted in a one-page bond paper
 Expect a site visit by the Internship Coordinator.
 Attend a seminar scheduled by the Internship Office. Announcement will be posted in
the Bulletin Board.
 Accomplishment Report signed by your supervisor.

Completion Phase (May 2018)

ENDTERM REQUIREMENTS – 30% of Total Grade

 Have yourself evaluated by your supervisor using the Trainee’s Performance Evaluation
form.
o Request your supervisor to place the accomplished form in a sealed white
envelope
o This is where 50% of your final grade will come from.

 Evaluate the training site by accomplishing the Site Evaluation Form.

 Submit Accomplishment report duly signed by your supervisor.
 Submit photocopy of the Certificate of Completion.
 Compile these documents in your long folder
 Last day of submission of ALL requirements is on May 18, 2018.

Note: LATE REQUIREMENTS WILL NOT BE ACCEPTED & NO EXTENSION OF TRAINING

WILL BE ALLOWED.
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 COMPANY PROFILE

(Computerized, should be one page only, explain nature of business, include company history
and highlight mission and vision)

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 INTERNSHIP INFORMATION SHEET 1x1 or 2x2
University of St. La Salle PICTURE

Date: __________________

Name of Trainee: _________________________________________________________

(Last) (First) (M.I.)
Course, Year & Section: ____________________________________________________

Home Address: _________________________________Mobile #: __________________

COMPANY NAME: _________________________________________________________

Company Address: ___________________________________ Tel. #: _______________

Manager/Owner: _________________________________________________________

Supervisor/Authorized Representative: ____________________ Position: ____________

Department/Division: ______________________________________________________

Date Started: ___________________ Expected Date of Completion: ________________

Job Description: __________________________________________________________

Fixed schedule of working hours/days:

MON TUE WED THU FRI SAT

AM
PM
Total Hours (1 week): _________

Submitted By: Noted By:

______________________________ __________________________________
Intern’s Signature over Printed Name Supervisor’s Signature Over Printed Name

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 INTERNSHIP OATH OF UNDERTAKING

I, _____________________________________, hereby attest that I have read and

understood the Internship Guidelines of the University of St. La Salle and will perform my
duties and responsibilities as a Student Intern in accordance with these guidelines.
I acknowledge my obligation to keep my Internship Coordinator informed regarding
my Internship experience for the duration of my Internship period.
I understand that I will not be issued a passing grade until I have complied with all the
requirements of the Internship Program within the specified period of time. I am aware of
the responsibilities should I commit at least one of the following violations:

REPORTED VIOLATION 1ST OFFENSE 2ND OFFENSE 3RD OFFENSE

1 Violation of company rules and
policies
2 Falsification of documents /
Forging of Signature
 Verbal warning  Dropped from the course  Call the parents/case conference
 Written explanation  Case conference with DC, Dean, with the special committee.
 Case conference with DC, Dean Coordinator, Discipline Officer &  Dismissal from the University.
& Coordinator Parents  Counseling session before the
 Case conference with DC, Dean,
 Counseling sessions release of transfer credentials.
Coordinator & Parents
 Conference with the
Coordinator & Company
Supervisor (to determine
whether to keep the intern in
the same site or need to
transfer)
 Additional work hours
 Referral to guidance office for
counseling
 Dropped from the course  Call the parents/case conference
 Case conference with DC, Dean, with the special committee.
Coordinator, Discipline Officer &  Dismissal from the
 University.
Parents
 Counseling session before the
 Counseling sessions
release of transfer credentials.

3 MINOR: Dishonesty Lying,
making false claims, fabricating
false information
 Verbal warning  Dropped from the course  Call the parents/case conference
 Written explanation  Case conference with DC, Dean, with the special committee.
 Case conference with DC, Dean Coordinator, Discipline Officer &  Dismissal from the University.
Parents
& Coordinator  Counseling session before the
 Counseling sessions
 Case conference with DC, Dean, release of transfer credentials.
Coordinator & Parents
 Conference with the
Coordinator & Company
Supervisor (to determine
whether to keep the intern in
the same site or need to
transfer)
 Additional work hours Referral
to guidance office for counseling

4 MAJOR: Dishonesty Logging in
and not reporting to duty,
copying someone else's term
report/cheating/deception
5 Failure to Attend Orientation
 Dropped from the course
 Case conference with DC, Dean,
Coordinator, Discipline Officer &
Parents
 Counseling sessions
 Cannot start OJT + 50hrs
 Call the parents/case conference
with the special committee.
 Dismissal from the University.
 Counseling session before the
release of transfer credentials.

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6 Failure to meet the deadline
for endorsement
7 Non-performance of duties.
Insubordination/disregard of
supervisor's instruction.
8 Absence Without Leave
(AWOL)
9 MINOR: Theft/stealing Stealing
of points, taking out office
supplies
10 MAJOR: Theft/stealing
11 Dress Code Violation
Inappropriate attire
12 Inflicting or attempting to
inflict physical injury
13 Slander/gossiping
 Additional 50hrs
 Verbal warning  Dropped from the course  Call the parents/case conference
 Written explanation  Case conference with DC, Dean, with the special committee.
 Case conference with DC, Dean Coordinator, Discipline Officer &  Dismissal from the University.
Parents
& Coordinator  Counseling session before the
 Counseling sessions
 Case conference with DC, Dean, release of transfer credentials.
Coordinator & Parents
 Conference with the
Coordinator & Company
Supervisor (to determine
whether to keep the intern in
the same site or need to
transfer)
 Additional work hours
 Referral to guidance office for
counseling
 Dropped from the course  Call the parents/case conference
 Case conference with DC, Dean, with the special committee.
Coordinator, Discipline Officer &  Dismissal from the University.
Parents.  Counseling session before the
release of transfer credentials.
 Counseling sessions
 One week suspension + 50hrs  Dropped from the course  Call the parents/case conference
duty  Case conference with DC, Dean, with the special committee.
 Counseling sessions Coordinator, Discipline Officer &  Dismissal from the University.
Parents
 Restitution/Reparation  Counseling session before the
 Counseling sessions
release of transfer credentials.
 Call the parents/case
conference with the special
committee.
 Dismissal from the University.
 Counseling session before the
release of transfer credentials.
 Verbal warning  Dropped from the course  Call the parents/case conference
 Written explanation Case  Case conference with DC, Dean, with the special committee.
conference with DC, Dean & Coordinator, Discipline Officer &  Dismissal from the University.
Parents
Coordinator  Counseling session before the
 Counseling sessions
 Case conference with DC, Dean, release of transfer credentials.
Coordinator & Parents
 Conference with the
Coordinator & Company
Supervisor (to determine
whether to keep the intern in
the same site or need to
transfer)
 Additional work hours
 Referral to guidance office for
counseling
 Verbal warning
 Written warning /Reprimand
 Verbal warning  Dropped from the course  Call the parents/case conference
 Written explanation Case  Case conference with DC, Dean, with the special committee.
conference with DC, Dean & Coordinator, Discipline Officer &  Dismissal from the University.
Parents
Coordinator  Counseling session before the
 Counseling sessions
 Case conference with DC, Dean, release of transfer credentials.
Coordinator & Parents
 Conference with the
Coordinator & Company
Supervisor (to determine
whether to keep the intern in
the same site or need to
transfer)
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14 Utilizing company facilities for
personal use
15 Damaging company properties
16 Selling to company
employees/Soliciting Money
from company employees.
Unauthorized solicitation of
money from company
employees/engaging in
business.
17 Reporting to work drunk
18 Out of place behavior: public
display of affection, boisterous
behavior, playing with
computer, texting.
19 Immorality. Being involved
with a superior.
_______________________________
SIGNATURE OF STUDENT
COURSE YR & SEC: _______________
 Additional work hours Referral
to guidance office for counseling
 Verbal warning
 Written explanation
 Case conference with DC, Dean
& Coordinator
 Case conference with DC, Dean,
Coordinator & Parents
 Conference with the
Coordinator & Company
Supervisor (to determine
whether to keep the intern in
the same site or need to
transfer)
 Additional work hours
 Referral to guidance office for
counseling
 Replace damaged property
 Letter of apology to the
company
 Verbal warning
 Verbal warning
 Verbal warning
 Dropped from the course
 Case conference with DC, Dean,
Coordinator, Discipline Officer &
Parents
 Counseling sessions
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 Dropped from the course
 Case conference with DC, Dean,
Coordinator, Discipline Officer &
Parents
 Counseling sessions
 Written warning
 Written warning
 Written warning
 Call the parents / case conference
with the special committee.
 Dismissal from the University.
 Counseling session before the
release of transfer credentials.
______________________________
NAME OF COMPANY
DATE: ________________________
 Call the parents/case conference
with the special committee.
 Dismissal from the University.
 Counseling session before the
release of transfer credentials.
 Dropped from the course Case
conference with DC, Dean,
Coordinator, Discipline Officer &
Parents
 Counseling sessions
 Dropped from the course
 Case conference with DC, Dean,
Coordinator, Discipline Officer &
Parents
 Counseling sessions
 Dropped from the course
 Case conference with DC, Dean,
Coordinator, Discipline Officer &
Parents
 Counseling sessions
 UNIVERSITY OF ST. LA SALLE
Bacolod City

INTERNSHIP PROGRAM

PARENT’S/GUARDIAN’S CONSENT

TO WHOM IT MAY CONCERN:

I hereby willingly and voluntarily consent to the Internship training of my

son/daughter, Mr./Ms._____________________, which will be at
_____________________ starting _______________ until _____________.

I have considered the benefits that my son/ daughter will derive from his/ her
training with the understanding that I will not hold any party responsible for any
untoward accident and/or incident which may happen to him/her during the above-
mentioned activity as long as due care and precautions are observed to ensure the safety
of the students.

I hereby affix my signature this _____day of ___________2017 at Bacolod City.

__________________________ __________________________
Printed Name of Parent/Guardian Signature

__________________________ __________________________
Address Telephone Number

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 UNIVERSITY OF ST. LA SALLE
Bacolod City

MONTHLY ACCOMPLISHMENT REPORT

NAME OF INTERN: _______________________________ COURSE YR & SEC: _________

COMPANY NAME: ________________________________ MONTH OF: ______________
NUMBER OF NAME & SIGNATURE OF
DATE TIME IN ACTIVITY TIME OUT
HOURS AUTHORIZED PERSON

TOTAL HOURS: _______________________

________________________________ __________________________
SIGNATURE OF INTERN DATE

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 UNIVERSITY OF ST. LA SALLE
Bacolod City

MONTHLY ACCOMPLISHMENT REPORT

NAME OF INTERN: _______________________________ COURSE YR & SEC: _________

COMPANY NAME: ________________________________ MONTH OF: ______________
NUMBER OF NAME & SIGNATURE OF
DATE TIME IN ACTIVITY TIME OUT
HOURS AUTHORIZED PERSON

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TOTAL HOURS: _______________________

________________________________ __________________________
SIGNATURE OF INTERN DATE

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 UNIVERSITY OF ST. LA SALLE
Bacolod City

MONTHLY ACCOMPLISHMENT REPORT

NAME OF INTERN: _______________________________ COURSE YR & SEC: _________

COMPANY NAME: ________________________________ MONTH OF: ______________
NUMBER OF NAME & SIGNATURE OF
DATE TIME IN ACTIVITY TIME OUT
HOURS AUTHORIZED PERSON

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12

13

14

15

TOTAL HOURS: _______________________

________________________________ __________________________
SIGNATURE OF INTERN DATE

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13
 PERSONAL INSIGHTS/ASSESSMENT GUIDE QUESTIONS
(Answers should be computerized on a short sized bond paper, minimum of 2 pages-2 questions
in 1 page.)

1. What did I learn FROM MY Internship experience in terms of Knowledge, Skills and
Attitude?

2. In what situation/s was I able to apply the Expected Lasallian Graduate Attributes (ELGA)?

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3. How are these learnings helpful in preparing myself for professional life after college?

4. What can I recommend for the improvement of the Internship Program?

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 UNIVERSITY OF ST. LA SALLE
Bacolod City

INTERNSHIP PROGRAM
TRAINEE’S PERFORMANCE EVALUATION

Name: _______________________________________ Date: ___________________

Course & Section: ______________________________ Sem: _______ A.Y. ________

Please rate the student’s performance according to:

1 – VERY GOOD 3 – FAIR
2 – AVERAGE 4 – POOR

FACTORS/VARIABLES Please Encircle

I. COMPETENCE (40%)
1. Exhibits workable knowledge and 1 2 3 4
Understanding of the assigned tasks
2. Expresses willingness to work in groups. 1 2 3 4
3. Receptive to ideas of the other people 1 2 3 4
4. Shows positive response to corrections 1 2 3 4
Made by his/her superiors
5. Submits quality work 1 2 3 4

II. ATTENDANCE AND PUNCTUALITY (30%)

1. Maintains regular OJT time 1 2 3 4
2. Reports to work on time 1 2 3 4
3. Notifies the Supervisor ahead of time 1 2 3 4
if unable to report for duty
4. Makes up for absences 1 2 3 4

III. COMMUNICATION SKILLS (20%)

1. Proficiency in English 1 2 3 4
2. Ability to express ideas and deliver 1 2 3 4
them clearly

IV. PERSONALITY (10%)

1. Physically neat in appearance 1 2 3 4
2. Relates well with people in a pleasing 1 2 3 4
Manner and maintains sincerity and fairness
When confronted with difficulties
3. Possesses self-confidence in his/her 1 2 3 4
Ability and shows a high level of initiative
4. Shows ability to manage time and identify 1 2 3 4
Priorities
Please write your comments or recommendations on the space provided to help improve the trainee’s
performance. ______________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Rated by:
_______________________________
Printed Name & Signature
_______________________________
Position

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 INTERNSHIP SITE EVALUATION

Name :_____________________________Course &Section:____________________

Company:___________________________________________

IMPROVEMEN
VERY GOOD
EXCELLENT

NEEDS
GOOD

POOR
FAIR
ITEM COMPANY EVALUATION

(5)

(4)

(3)

(2)

(1)
(0)
T
Was the company appropriate for your type of
1 training required and/or desired
Remarks/
Suggestions
Has the company designed the training to
2 meet your objectives and expectations
Remarks/
Suggestions
Has the company showed coordination with
3 USLS in the design and supervision of the OJT
Remarks/
Suggestions
Has the company and its staff welcomed you
4 and treated you with respect and understanding
Remarks/
Suggestions
Has the company facilitated the training, including the
5 provision of the necessary resources such as facilities and
equipment needed to achieve your OJT objectives
Remarks/
Suggestions
Has the company assigned a supervisor
6 to oversee your work
Remarks/
Suggestions
Has the supervisor been effective in his/her supervision
7 through regular meeting, consultation or advise
Remarks/
Suggestions
Has the training provided you with the necessary technical
8 and administrative exposure of real world business/office
problems and practice
Remarks/
Suggestions
Has the training program allowed you to develop self-
9 confidence, self-motivation and positive attitude towards
work
Remarks/
Suggestions
Has the experience improved your personal
10 skills and human relations
Remarks/
Suggestions

Signature Over Printed Name: __________________________________

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 CERTIFICATE OF COMPLETION
(Photocopy only, but the original should be seen by the Internship Coordinator)

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