PROPOSED WORK

IMMERSION FORMS
Technical – Vocational – Livelihood (TVL)

[DATE]
[COMPANY NAME]
[Company address]
30 September 2022

RANDIE L. SALONGA
Principal IV
CNHS, Cavite City

Thru: REA H. TOPACIO

Assistant Principal II

Dear Sir:

In view of the upcoming 2nd Semester where our grade 12 students are required to undergo Work
Immersion as part of the requirements for graduation, the undersigned would like to submit the following
documents for your comments/approval:

1. Parents/ Guardian’s Waiver

2. Letter of Introduction
3. Request for Work Immersion Endorsement Letter
4. Company Acceptance Form
5. List of Tasks / Activities
6. Work Immersion Schedule
7. Teachers’ Program

Also, I would like to ask for your approval to conduct a Parents Orientation on Oct 14, 2022 in CNHS-
SHS Covered Court attached here is a proposal for your perusal.

Respectfully yours,

VILMA V. BAUTISTA
Master Teacher I
Subject Group Head for TVL
 Parents’ / Guardians’ Waiver
This is to certify that I am allowing my son/daughter __________________________ to go on a
work immersion program for 80 hours starting on ___________________________ until
________________________ at ___________________________________________________,
as a part of the required curriculum for the Senior High School (SHS) of Cavite National High
School (CNHS).

It is understood that she/he abides by the rules and regulations that may be imposed by the
Supervisor/Staff-in-Charge for his/her welfare and safety and that there is no employer-employee
relationship between the school and the student-participant.

I fully agree to remove and waive any claims and responsibility on the part of the CNHS – SHS
and ___________________________________________, and/or the representative/s, in case of
my untoward incident, injury or loss that may happen to my son/daughter during the duration of
the work immersion.

Name of Parent
(Signature over printed name)

Res. Cert. No. ________________________________

Issued on: ___________________________________
Issued at: ____________________________________

Student’s Name: ___________________________________________________

Address: _________________________________________________________
Contact No.: _______________________________________________________

SUBSCRIBED AND SWORN TO BEFORE ME, this

___________________________________________ day of _____________________,
20_______ at _______________________________, Philippines.

Doc. No. _____________

Page: No. _____________
Book: No. _____________
Series of ______________
_____________________________
Date

Mr. / Ms. CONTACT PERSON

Position
Name of the Company
Company Address

Dear Sir / Madam:

This is to introduce Name of the Student who is a grade 12 student enrolled in our Technical-
Vocational-Livelihood (TVL) track, Home Economics (HE) strand, with specialization in
Food and Beverage Services (FBS) NCII, and to further endorse his/her application with your
company to undergo 80 hours work immersion program as a requirement of the DepEd K-12
Curriculum for Senior High School Program.

We believed that the school must link up with industry to update, upgrade and make the
education of our youths more relevant to the actual needs of the industry.

Together with this letter is an Acceptance Form. We request that the said form be accomplished
and returned to this office upon acceptance of the student in your company.

We are confident that the given opportunity, our student will be an asset to your company.

Thank you for the favorable action and we look forward to a more fruitful linkage with you.

Very truly yours,

OJT Program Coordinator

Signature Over Printed Name

Noted by:
 Request for Work Immersion Endorsement Letter

Company Name: _______________________________________________________________

Company Address: ______________________________________________________________
Contact Person: _______________________________ Telephone No./s : _________________
Position: ________________________________________
Student Name: ___________________________________ Grade/Section: ________________
Contact No. _____________________________________ LRN # ______________________
Class Adviser: ___________________________________ Contact Number: ______________

Time Alloted for

Class Schedule for the Current Semester
Work Immersion

Subject Units Grade/ Time Days Room Days Time

Section

Note: please attach the following: Endorsed for Initial Interview and
Physical Examination by:
€ Resume in prescribed format

€ Parents’ / Guardians’ Waiver

Work Immersion Teacher
€ Photocopy of the school ID

€ Photocopy of Insurance

Initial Interview Physical Examination OJT Pre-Deployment

Briefing
 Referral Letter Issued Referral Letter Reviewed Noted/Approved:
by/Date by/Date

Teachers’ Copy
Work Immersion Program
Company Acceptance Form

This is to certify that ___________________________________________________________

has been accepted in our company
_______________________________________________________________ with the address
at ____________________________________________________________________ for the
Work Immersion starting ______________________ with pertinent information as follows:

Department / Unit Assigned : ____________________________________

Name of the Immediate Supervisor : ____________________________________
Contact Information : ____________________________________
Work Schedule : ____________________________________
Training Duration : ____________________________________

__________________________________________________
Signature Over Printed Name of the Company Representative

Students’ Copy
Work Immersion Program
 Company Acceptance Form

This is to certify that ___________________________________________________________

has been accepted in our company
_______________________________________________________________ with the address
at ____________________________________________________________________ for the
Work Immersion starting ______________________ with pertinent information as follows:

Department / Unit Assigned : ____________________________________

Name of the Immediate Supervisor : ____________________________________
Contact Information : ____________________________________
Work Schedule : ____________________________________
Training Duration : ____________________________________

__________________________________________________
Signature Over Printed Name of the Company Representative
 Work Immersion
List of Tasks / Activities
Name of Student Grade and
Section

School Immersion
Venue

Track Strand /
Specializato
n

Duration of Work
Immersion

School Contact
Parnerships Focal Number
Person

Work Immersion Contact

Teacher Number

LIST OF TASKS / ACTIVITIES

Competencies Tasks / Time Allotment Actual Remarks
Activities Schedule
Students shall not be given other activities outside of those previously agreed upon, which are
anchored on the stated competencies.

Certified true and correct:

___________________________________ ____________________________________

Student’s Signature Over Printed Name Parent’s Signature Over Printed Name

___________________________________ ___________________________________

Student’s Signature Over Printed Student’s Signature Over Printed Name

 PROSPOSED WORK IMMERSION SCHEDULE
GRADE 12 – TVL

(Please see attached training matrix)

Note:
● Students who will be scheduled for work immersion will be excused from their class in
the duration of their scheduled work immersion. (2 weeks)
● Subject teachers will provide students with Computer Assisted Instruction or Intervention
Materials for the students to comply with the requirements missed due to their work
immersion schedule.