INTERNSHIP INFORMATION AND ACCEPTANCE FORM

On-the-Job Training 2

Course: BS in Information Technology Internship Semester & Year: 2nd Sem 2022-2023

Student Number: 19-1233___________________

Student Name: Palacpac, Mary Jane S._________
TO BE COMPLETED BY STUDENT AND REVIEWED WITH THE IMMEDIATE SUPERVISOR
Company Name: Commission on Audit (Chairman’s Office)

Address: Commission On Audit, Commonwealth Avenue, Quezon City Philippines

Internship Hours: 300 hours

Internship Start Date: January 30, 2023

Internship Schedule:
Monday Tuesday Wednesday Thursday Friday Saturday
8:00 – 5:00 8:00 – 5:00 8:00 – 5:00 8:00 – 5:00 8:00 – 5:00
Note: if not Note: if not
face to face face to face

TO BE COMPLETED BY THE COMPANY

We, ___________________ Commission on Audit ____________________, accept internship

application of Palacpac, Mary Jane S. to serve in our company.

Authorized Representative Signature: _______________________________________________

Date: January 30, 2023

Name: _________Evangeline M. Fabul______________
Position: __Administrative Officer V_________________
Department: _Chairman’s Office_____________________
Contact Number: __8931-9266____________________________

Student Signature: _____________Palacpac, Mary Jane S._____________________

Date: ________January 30, 2023______________
Parent/Guardian Signature: _____________________________________________
Date: ______January 30, 2023_____________
Name: ____Palacpac, Milani S._______________________
Address: ______16E Sikap Area, Republic Ave. Fairview Quezon City ______