----4 Republic of the Philippines

____________________) s.s.

Student Waiver for OJT

I, ___________________________, of legal age, Filipino, and resident of

______________________________________, after having been sworn it in accordance with law
hereby deposes and state:

That I am a Senior High School Student of Electron College of Technical Education.

Which is in the process of my Work Immersion with the

___________________________________________________________________________
(Name of the Company)

That the completion of the requirements of Work Immersion as prescribed by DepEd and
the student requesting with regarding the school waiver, the school and the company is not
responsible for any misconduct of the student, and there is no obligation to whatever
accountabilities occur.

This affidavit is executed to attest to the truth of the foregoing and for whatever legal
purposes and intent it may serve her/him best.

IN WITNESS WHEREOF, I hereby signed this affidavit this ______ day of _____, 2023
at ____________________________,

_______________________
(AFFIANT)
(Signature over Printed Name)

VERLYN F. AREOLA __________________

OJT Program Head Parent/Guardian
(Signature over Printed Name)

SUBSCRIBED AND SWORN to before me this ______ day of _____________________ 2023,

in __________ Philippines, affiant exhibiting to me his/her _______ issued on ________ at
______

NOTARY PUBLIC

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