STUDENT INTERNSHIP COMMITMENT FORM

I am PRINCESS ANN R. PENDON ,22_ yrs. old and a _4TH _ year student of
the ILOILO STATE UNIVERSITY OF FISHERIES SCIENCE AND TECHNOLOGY – MAIN CAMPUS –
POBLACION SITE, College of Information and Communications Technology.

In partial fulfillment of the requirements for my degree of Bachelor of Science in Information Technology, I
shall be undergoing an internship training for a total of ___500 __hours/weeks starting on February
1,2024_until _April30,2024 at ISUFST-MAIN-POBLACION SITE .

In relation to the said internship training, I hereby commit to:

1.) Undergo the pre-internship training or orientation to be conducted by ISUFST-MAIN CAMPUS-

POBLACION SITE and by ISUFST Main Campus Poblacion Site (CIT OFFICE).
Host Training Establishment (HTE)
2.) Properly inform my parents or the person(s) exercising parental authority over my person of the
nature of the activity I am joining and secured their consent for my participation. I likewise commit to
ensuring their advice on the measures which I am to undertake for my personal safety and security in
relation to my involvement in the said activity;
3.) Take the necessary precautions to avoid or get involved in any incident that could cause loss,
damage, or injury to my own person or that of another;
4.) Undergo further medical test, and should I be found out suffering from any medical condition
that may be exacerbated or aggravated by participating in such activity, I commit to immediately report
the same in writing and submit pertinent documents to the assigned SIPP/OJT coordinator and to excuse
me from the said activity;
5.) Strictly observe ISUFST Offices rules on security and confidentiality of business information
and other regulations that may be implemented by my direct supervisor and our SIPP/OJT practicum
coordinator in relation to my training;
6.) I understand that the training may not involve any compensation to the student – intern on the duration
of the training, it is not a contract for employment, and the company is not obliged to hire me after the training;
7.) Report for internship to ISUFST CIT Offices based on the stipulated schedule in the contract and
complete the agreed duration of the internship;
8.) Perform tasks and activities indicated in the internship plan;
9.) Submit an internship journal to ____________ SIPP/OJT practicum coordinator reflecting on the
approved internship plan, activities done, any problem/s encountered, and reflections on the internship experiences.

___________________________
Signature of Student /Trainee

___________________________
Date Signed

STUDENT INTERN’S CURRICULUM VITAE

I. PERSONAL INFORMATION:
Name: _PENDON________PRINCESS ANN__________ _R.____________________Civil Status: _Single_
Last First M.I. Date of Birth __06/10/2002_ Age:_21_
 Sex: Male Female Height: _5’5 Weight: 45kg
Home Address: ___Brgy. Agnaga, Concepcion Iloilo__________________________ ____
Present Address: _ ___Brgy. Agnaga, Concepcion Iloilo__________________________
Physical disability (if any): __N/A___________________________________________________________
Contact Person (In case of Emergency): Rochel Pendon Contact No.: +639126105366___

II. FAMILY INFORMATION:

Father’s Name: Greg Pendon______________ Occupation: __Driver____________
Mother’s Name: _ Rochel Pendon_____________ Occupation: __Housewife_______________
Parent’s Address: __ Brgy. Agnaga, Concepcion Iloilo__________________________
Contact No.: __+639126105366_________________________________________________________
Messenger: ____ Rochel Pendon ______ Email Address: rochelpendon@gmail.com

III. EDUCATIONAL BACKGROUND

Elementary____Domingo Y. Sobremonte Memorial School
High school: ___San Juan Academy Inc.
__________________________________________
Vocational: ____________________________________________________________________________
College: _______________________________________________________________________________

IV. PREVIOUS TRAINING (IF ANY)

Trade Inclusive date Length in Hours Conducted By

V.WORK EXPERIENCE (IF ANY)

Position Inclusive Date Status of Appointment Last Salary Agency/Company

VI. SPECIAL SKILLS AND QUALIFICATION

________________________________________________________________________________________________________
________________________________________________________________________________________________________
____
I hereby certify that the information given above is true and correct to the best of my knowledge.

__________________________________________
Signature Over Printed Name of Student/Trainee

EMPLOYER AND STUDENT-INTERNS INTERNSHIP AGREEMENT

This AGREEMENT, entered into this ________ day of ______________, _____________by and between
___________________________________________________________ with business address at
_____________________________IRVIN M.
HARO,PHD________________________________________________________
(Name of Host Training Establishment)
referred to as HTE and __________PRINCESS ANN R. PENDON______________________________________________
(Name of Student-Intern)
Born on _____APRIL 19,2001___ and residing at _Brgy. Agnaga concepcion iloilo_
herein after referred to as STUDENT-INTERN.

WITNESSETH: That the HTE and the student-intern do hereby mutually agree and bind themselves as follows:

1. The HTE agreed to employ and train the STUDENT-INTERN, and the STUDENT-INTERN agrees to apply
himself/herself diligently and faithfully to work in the field of _________________ during the period of internship in
compliance with CMO No. 104 s. 2017 approved for the aforementioned field and made part of this AGREEMENT, under
the following terms and conditions:
a. Period of Internship _______________500_________________________________ hours/weeks
b. Area of Assignment ___ISUFST- Main Campus Poblacion Site (ISUFST) -CIT OFFICE
c. Location Ilaya Poblacion, Barotac Nuevo Iloilo
d. Duty Schedule (if applicable) Monday to Friday 8:00 am to 5:00 pm
e. Unit Head / HTE Focal Person _Irwin M. Haro, PHD
f. Start of Internship FEB. 1,2024
g. Approximate Date of Completion of Internship April 1, 2024
2. The schedule of work processes in which the Student-Intern is to receive adequately supervised internship and experience,
of which a record shall be kept and periodically evaluated.
3. The Student-Interns shall work the equivalent of eight (8) hours a day in this training course. Overtime work may be
allowed provided the hours of work rendered are duly credited to hours of training to shorten the period of training. After
completing the required internship hours/weeks, the HTE may extend student-interns services provided they will be given
due compensation.
4. In support of this collaboration, and to enable the students' interns to maximize their time and learning with the HTE, the
student-interns shall:
a. be assigned to areas or given work assignments that are meaningful and will make use of the students’ competencies
and skills in the discipline;
b. not be given personal and menial tasks that are unrelated to the discipline;
c. not be given work assignments that are dangerous or will expose them to risk or harm, and;
d. be dealt with in a professional manner, and all office transactions and interactions between the student- intern and the
HTE's employees be strictly confined to professional work dealings and engagements.
5. The internship may be terminated for the following due reasons:
a. Any act of gambling, theft, and other similar illegal acts
b. Submitting forge or fraudulent documents
c. Any act in violation of the HTE's rules and regulations in accordance with the internship program
d. Any act in violation of the laws of the country
e. Physical or medical conditions

In witness whereof, the parties have signed this Agreement at ____________________________ this _____________________
day of _________________________.

ISUFST Main Campus Poblacion Site/CIT office

__________IRVIN M. HARO, PHD____________________________ PRINCESS ANN R. PENDON

Partner Institution / Onsite Supervisor Student-intern

INTERNSHIP GENERAL AGREEMENT FORM

I. The ____________ISUFT(CIT OFFICE)__________________ will permit

Host Training Establishment (HTE) ___
PRINCESS ANN R. PENDON_________ __________________BSIT4-B___________________
(Student – Intern) (Course, Year & Section)
to enter their establishment for the purpose of training experience in Information technology____________
________________________________________________________.

II. The course training is designed to last for a minimum of ___500________ hours/weeks, and the student intern
will work the equivalent of eight (8) hours per day during the duration of the training course.
III. The Partner Institution (HTE) shall prepare the schedule of work activities with the Faculty Practicum
coordinator's assistance.
IV. The student-intern will not be paid any compensation; however, HTE may give any form of incentive if they
desired to do so.
V. While in training, the student will have a status of student/ trainee not displacing or substituting a regular
worker of the HTE.
VI. The student/trainee will not be permitted to remain in one area of assignment of the occupation beyond the
period of time necessary for him/her to become proficient to gain occupational experiences unless agreed upon
by the Faculty practicum Coordinator and the Partner Institution (THE).
VII. The parent or guardian shall be responsible for the student/trainee's personal conduct while in the internship.
VIII. All complaints shall be directed to the SIPP Coordinator, who will make the necessary adjustment.
IX. The student's training – intern, shall conform to the local policies, rules, and regulations of the Partner
Institution (HTE).
X. The Faculty Practicum Coordinator/partner institution shall have the authority to transfer or withdraw the
student- intern at any time for cause.

RENANTE A. DIAMANTE, DIT ISUFT Main Campus Poblacion (CIT OFFICE)

Faculty practicum Coordinator Partner Institution (HTE)

RENANTE A. DIAMANTE, DIT IRVIN M. HARO, PHD

Dean Representative of Partner Institution (HTE)

SAMUEL B. TALVES, PHD

Chair, Academics PRINCESS ANN R. PENDON
Student/Trainee

JHON PETER VELASCO,MHM ROCHEL PENDON

Chair, Advancement & Linkages Parent/Guardian/Spouse

PARENT’S /GUARDIAN’S CONSENT

Know All Men By These Presents:

I, ___ROCHEL PENDON________________________, of legal age, ___48_______ (citizenship), and resident of

__Brgy. Agnaga Concepcion Iloilo________________________________, Philippines, contact no.
_09126105366_________________ after having duly sworn to in accordance with the law, do hereby depose and state:

That I am the parent/guardian/Spouse of __PRINCESS ANN R. PENDON____________________, a __4th ____ year

Bachelor of Science in Information Technology student at Iloilo State College of Fisheries , _________MAIN____ Campus,
POBLACION SITE___, Iloilo.

That I am permitting my son/daughter/spouse to undergo an internship training program for a total of

___500______ hours/weeks starting on _FEB.1,2024_________ until APRIL 1, 2024_ a t I S U F S T M a i n C a m p u s -
P o b l a c i o n S i t e , in partial fulfillment of the requirements for the degree of BS INFORMATION TECHNOLOGY.

That my son/daughter /spouse understands that he/she should strictly observe the rules and regulations of
_____________________________________ and ISUFST- MAIN CAMPUS POBLACION SITE______ as stipulated in
the contract and training plan, in relation to the said training program and to observe all other regulations that may
be implemented by his/her direct supervisor in relation to the same.
 That my son/daughter/spouse will submit the necessary reports and requirements stipulated in CMO # 104 S.
2017 before and after the internship.

That my son/daughter/spouse will report first and foremost to ISUFST-MAIN CAMPUS POBLACION SITE __
any incident that may occur during the training which may jeopardize his/her internship and/or well-being.

ROCHEL PENDON

Signature over Printed Name of Parent/Guardian/Spouse

Date

REPUBLIC OF THE PHILIPPINES

(City/Municipality of ____________________s.s.)

ACKNOWLEDGEMENT

BEFORE ME, a Notary Public for and in the (Province/City/Municipality) of _______________, personally appeared
______________________________ with Government Issued ID no. _______________ issued on __________________at
_______________________, known to me and to me known to be the same person who executed the foregoing instrument which
(he/she) acknowledged to me as (his/her) free and voluntary act and deed, consisting of only one (1) page, including this page in
which this Acknowledgement is written, duly signed by (him/her).

WITNESS MY HAND AND SEAL this _____________________at ________________________, Philippines.

NOTARY PUBLIC

______________________

_______________________________
_______________________________
_______________________________
_______________________________

Dear _________________________:

The Iloilo State College of Fisheries Science and Technology- MAIN CAMPUS POBLACION SITE Campus is
requiring all 4th year students enrolled in the Bachelor of Science in Information Technology Program to complete
the _500______hour On-the-Job Training with an institution or company engaged in a related industry.

We seek your support and partnership in the implementation of this student program from our college to join your
company's Student Internship Program and subsequently complete their prescribed OJT hours. They will be ready
to start with this activity on ____________________.

We hereby endorse _PRINCESS ANN R. PENDON____________ to your Internship Program.

In support of this collaboration, and to enable the students to maximize their time and learning with your firm and
ensure their safety as well, may we request that the students:

o be assigned to areas or given work assignments that are meaningful and will make use of the
students’ competencies and skills in the discipline,
 o not be given personal and menial tasks that are unrelated to the discipline,
o not be given work assignments that are dangerous or will expose them to risk or harm, and;
o be dealt with in a professional manner, and all office transactions and interactions between the
student and the Company's employees be strictly confined to professional work dealings and
engagements.

Thank you very much, and we look forward to our continuing partnership in the development of our students and
soon-to-be professionals.

Very truly yours,

Dean / Faculty Practicum Coordinator

RENANTE A. DIAMANTE, DIT

Dean,CICT

STUDENT INTERNSHIP TRAINING AGREEMENT FORM

I a m PR INC E SS ANN R . PE NDON , 22 __ yrs. old and _4 TH _____ year student of the ILOILO STATE
COLLEGE OF FISHERIES SCIENCE AND TECHNOLOGYY – MAIN CAMPUS POBLACION SITE, INFORMATION AND
COMMUNICATION TECHNOLOGY( College Name).
In partial fulfillment of the requirements for my degree of Bachelor ofScience in Informtion Technology, I shall be undergoing
internship training for a total of Four Hundred Ninety (490) hours/weeks starting on FEB.1,2024 until APRIL
1,2024 , a t ISUFST MAIN C AMPUS- POB LACION SITE (CIT OFFICE)

In relation to the said internship training:

a) I take it as my responsibility to take the necessary precautions to avoid or get involved in any incident
that could cause loss, damage, or injury to my own person or that of another;

b) I understand that I must be sufficiently healthy or free from any medical condition that may be
aggravated by my participation in such an activity. Should I be suffering from any medical condition
that may be exacerbated or aggravated by participating in such activity, I commit to immediately
report the same in writing to the assigned faculty practicum coordinator and to excuse myself from the
said activity;

c) Undergo the pre-internship training or orientation to be conducted by ISUFST- MAIN CAMPUS POBLACION
SITE, INFORMATION AND COMMUNICATION TECHNOLOGY (Name of College).

d) I understand that the training may not involve any compensation to the student on the duration of the training, it is
not a contract for employment, and the company is not obliged to hire student-trainees after the training;

e) I hereby declare t ha t I understand that I should strictly observe

_____________________________________________________'s rules on security and confidentiality of
business information and other regulations that may be implemented by my direct supervisor and our
faculty coordinator in relation to my training;

f) Report for internship to ________________________________________________________ based on the

stipulated schedule in the contract and complete the agreed duration of the internship;

g) Perform tasks and activities indicated in the internship plan;

h) Submit an internship journal to the OJT practicum coordinator reflecting on the approved internship plan,
activities done, any problem/s encountered, and reflections on the internship experiences;

i) I have properly informed my parents or the person(s) exercising parental authority over my person of the
nature of the activity I am joining and had secured their consent for my participation. I likewise secured
their advice on the measures which I am to undertake for my personal safety and security in relation
to my participation in the said activity;

___________________________
Signature of Student

____________________
Date Signed