HINIGARAN NATIONAL HIGH SCHOOL

SENIOR HIGH SCHOOL

Internship Program

PARENT’S/GUARDIAN’S CONSENT

I hereby willingly and voluntarily consent to the Internship training of my son/daughter,

Mr./Ms.___________________, which will be at ________________ (company) 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 _____________, 2015 at Hinigaran, Negros Occidental.

_______________________________ ______________________________
Printed Name of Parent/Guardian Signature

Address: __________________________________________ Telephone Number: ________________

OATH OF UNDERTAKING

I hereby attest that I have read and understood the Internship Guidelines and will perform my duties and
responsibilities as a Student Intern in accordance with these guidelines.

I will abide by the Policies set by the Internship Program and I am aware of the consequences if I violate these
Policies.

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.

___________________________________ ___________________________________
Signature of Student above Printed Name Date Signed

Conforme:

__________________________________________ ___________________________________
Signature of Parent/Guardian above Printed Name Date Signed