Reference No.: OMSC-Form-COL-13 Effectivity Date: August 08, 2023 Revision No.

02

Revision No.02

Republic of the Philippines

OCCIDENTAL MINDORO STATE COLLEGE
Murtha, San Jose, Occidental Mindoro
Website: www.omsc.edu.ph Email address: omsc_9747@yahoo.com
Tele/Fax: (043) 457-0231

College of Agriculture

SUMMARY OF INTERNSHIP ACTIVITIES

Name: Date:
Internship Site:
Date of Internship:

Name and Address of Cooperating

Agency:

Name and Title of Site Supervisor:

Brief Description of the division or unit of

Organization where you completed work:

Description of responsibilities and

Experiences:

Description of key to accomplishments or Outcomes:

Signature of Intern:

Signature of Site Supervisor: