Department of Education

Schools Division of Negros Oriental

NEGROS ORIENTAL HIGH SCHOOL-SENIOR HIGH SCHOOL
Kagawasan Avenue, Daro, Dumaguete City

WORK IMMERSION PARENTAL CONSENT

Instruction: Please complete the following, sign and return to:

Mrs. Angelica G. Zambrano, Work Immersion Teacher

Name of student: ____________________________________________________Age: _________

Section: ABM 12-WALKER
Name of Parent/Guardian: _________________________________________________________
Address: _________________________________________________________________________
Mobile Number: _____________________

Emergency contact details: (If different from above)

Name: ___________________________________________________Tel /Mobile No.: ____________

Relationship to the student: ___________________________________________________________

Negros Oriental High School –Senior High School, Schools Division of Negros Oriental is committed
to provide its Senior High School students an exposure in a work- related environment to their field of
specialization through the Work Immersion Program, in order for them to enhance their learning
competence. The School through the Work Immersion Teacher will perform due diligence in
supervising and monitoring our Work Immersion students during the entire duration of the program.
The school, however, shall not be responsible for any untoward incident, God forbids, due to
negligence or any deliberate act on the part of the student or third party. The Work Immersion Teacher
shall observe due diligence and shall expect the same observance and responsibility of the student and
parents to avoid any untoward incident.

CONSENT (please read carefully)

a) I am allowing my son/ daughter to participate in the Immersion Program as a requirement of the

SHS Curriculum.
b) I fully support the Work Immersion undertaking of my son/daughter through minimal financial
cost, e.g. Transportation cost, uniform and other relevant expenses incurred during the course of
his/her work immersion.
c) I consent to my son/ daughter travelling by any form of transportation in the course of his/her
Work Immersion.
d) I understand that my son/daughter will undergo an 80-hour (4 hours a day for 20 days)
Immersion to the assigned company/unit identified by the immersion teacher duly approved by
the school’s Teacher In-charge starting January 12,2024 until the completion of the program.
e) I am allowing my son/daughter to attend pre-immersion activities, e.g. interview, job orientation
as may deem necessary.

Signed ___________________________________________
(Parent/ Guardian’s Signature over printed name)

Date: ____________________________________________