Company Acceptance Form

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Supervisor’s Copy

Department of Education
Region VI – Western Visayas
Division of Iloilo City
BO. OBRERO NATIONAL HIGH SCHOOL- Senior High School
Dama de Noche St., Bo. Obrero, Iloilo City
School ID: 302743
Senior High School

Work Immersion
Company Acceptance Form
This is to certify that ___________________________________________________ of _______________________ has been accepted in your
(Name of Learner) (Strand)
company ____________________________________________________________________________________________________________________________ with
(Name of Company)
address at _____________________________________________________________________________________________________________________________
(Address of Company)
for Work Immersion starting on ____________________________________ with pertinent information as follows:
Department/Unit Assigned: __________________________________________________
Name of Immediate Supervisor: _____________________________________________
Contact Details:________________________________________________________________
Work Schedule: ________________________________________________________________

Work Immersion Partner Institution Supervisor Work Immersion Teacher

________________________________________________________ SHEENA MARIE L. CELIZ


Signature over Printed Name Work Immersion Teacher

Learner’s Copy
Department of Education
Region VI – Western Visayas
Division of Iloilo City
BO. OBRERO NATIONAL HIGH SCHOOL- Senior High School
Dama de Noche St., Bo. Obrero, Iloilo City
School ID: 302743
Senior High School

Work Immersion
Company Acceptance Form
This is to certify that ___________________________________________________ has been accepted in your
(Name of Learner)
company ______________________________________________________________________________________________ with
(Name of Company)
address at _______________________________________________________________________________________
(Address of Company)
for Work Immersion starting on ____________________________________ with pertinent information as follows:
Department/Unit Assigned: __________________________________________________
Name of Immediate Supervisor: _____________________________________________
Contact Details:________________________________________________________________
Work Schedule: ________________________________________________________________

Work Immersion Partner Institution Supervisor Work Immersion Teacher

________________________________________________________ SHEENA MARIE L. CELIZ


Signature over Printed Name Work Immersion Teacher

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