WORK IMMERSION FORM

Name: ______________________________________________ Strand: __________________

Adviser: ____________________________ Date: ______________ Time: From: ________To: ________

Pre-Immersion Checklist

Understanding work immersion

Expected behavior
Work Ethics
Safety in workplace
Workplace rights and responsibilities
Confidentiality in the workplace
Effective conflict resolution and teamwork skills
Work Immersion rules and Regulations
Terms and conditions of the Memorandum of agreement

Appreciating the importance of credentials

Writing resume
Filling out application form
Job Interview skills training

Discussion of Portfolio
Portfolio Instructions
Portfolio Content
Accomplished forms
Pictures of worksite and nonwritten output/ projects with captions.
Illustrations of activities performed
Weekly diary
Sample written output
Work immersion highlights
Other relevant pictures / documents
When to update content
Portfolio Packaging
Portfolio presentation at the end of Work Immersion

Checked by:

____________________________

Immersion Teacher

____________________________
Jimmy P Morato

Work Immersion Coordinator

____________________________

Crisanto R. Salonga, PhD.

Principal

WORK IMMERSION

2x2 picture

STUDENT PROFILE:

Given Name: ________________ Surname: __________________ Middle Name: __________________

Grade/ Section/ Strand: ____________________________ Adviser: _____________________________

Company Name: ______________________________________________________________________

Company Address: _____________________________________________________________________

Duty Hours: ____________________________________Total Immersion Hours: ___________________

PERSONAL INFORMATION:

Age: ____ Birthday: ______________________ Gender: ______________ Civil Status: _______________

Contact No.: _____________________ Citizenship: __________________ Religion: _________________

EDUCATION:
Elementary: _______________________________________________ Year Graduated: _____________

Junior High school: __________________________________________Year Graduated: _____________

Person to be notified in Case of Emergency: __________________________ Contact No.: ____________

TABLE OF CONTENTS
Pre-Immersion
Application Letter to partner industry/business
Pre-Immersion Resume
Accomplished Clearance Checklist/Work Immersion Application

Immersion Proper
Narrative of Company Profile (May contain charts, diagrams, photos, illustrations or tables.)
Organizational Chart of the Partner Company
Narrative of the Company/Business Operation
Business Process Flow/Company Operational Flow
Weekly Diary (written)
Narrative/ Account of Learnings and achievements
Issues faced and Corresponding resolutions
Pictures of work site with description
Illustrations of Activities Performed
 Sample written output/project output/task output.

Post-Immersion
Accomplished Work Immersion Forms
Narrative Summary of Work Immersion (Consolidated Weekly Diary)
Work immersion highlights (Photos at work with description)
Other relevant pictures/documents (Certificate of Completion)
Written Reflections
Updated Resume (With inclusive new skills/knowledge acquired)
Photo Gallery (Consolidation of work immersion photos)
Supervisor’s Rating (Student Rating Sheet)

*All items indicating “WRITTEN” tasks must be hand written by the students

Note: Narrative which may contain charts, diagrams, photos, illustrations or tables. It can be a short history

COMPANY PROFILE
Note: Place the illustration or photo of the organizational chart of the assigned partner company.

ORGANIZATIONAL CHART
Note: State how does the partner company/industry/business operates including the operation period.

NARRATIVE OF COMPANY/BUSINESS OPERATION

Note: Draw the diagrammatic illustration of the partner company/industry/business operation to clients.

BUSINESS PROCESS FLOW

Note: Weekly diary must be hand written and validated by the Supervising Personnel.

Name: ___________________________________________________ Week No.: __________________

Track/ Strand: __________________________________________________________________

WEEKLY DIARY
 No. of Hours Signature of
Date Activities
Rendered Supervisor

Monday

__________

Tuesday

__________

Wednesday

__________

Thursday

__________

Friday

__________

Saturday

__________

Sunday

__________
Checked by:

_______________________________________

Work Immersion Teacher

Note: Weekly diary must be hand written and validated by the Supervising Personnel.

Name: ___________________________________________________ Week No.: __________________

Track/ Strand: __________________________________________________________________

WEEKLY DIARY
 No. of Hours Signature of
Date Activities
Rendered Supervisor

Monday

__________

Tuesday

__________

Wednesday

__________

Thursday

__________

Friday

__________

Saturday

__________

Sunday

__________
Checked by:

_______________________________________

Work Immersion Teacher

Note: Weekly diary must be hand written and validated by the Supervising Personnel.

Name: ___________________________________________________ Week No.: __________________

Track/ Strand: __________________________________________________________________

WEEKLY DIARY
 No. of Hours Signature of
Date Activities
Rendered Supervisor

Monday

__________

Tuesday

__________

Wednesday

__________

Thursday

__________

Friday

__________

Saturday

__________

Sunday

__________
Checked by:

_______________________________________

Work Immersion Teacher

Note: Picture of Worksite must include work areas where students-trainee were assigned. Some shots can be taken
where students are on the site.

PICTURE OF WORKSITE

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________
 ______________________________________________________________

______________________________________________________________

______________________________________________________________

Note: Picture of students at work. Photos must show students are working. Formal shots and NO wacky shots. Place a
description of the task that the student is performing.

ILLUSTRATIONS OF ACTIVITIES PERFORMED

(DAILY ACTIVITY LOG)

Day ___

_________________________________________________________

_________________________________________________________

_________________________________________________________
 Day ___

_________________________________________________________

_________________________________________________________

_________________________________________________________

Note: Picture of students at work. Photos must show students are working. Formal shots and NO wacky shots. Place a
description of the task that the student is performing.

ILLUSTRATIONS OF ACTIVITIES PERFORMED

(DAILY ACTIVITY LOG)

Day ___

_________________________________________________________

_________________________________________________________

_________________________________________________________
 Day ___

_________________________________________________________

_________________________________________________________

_________________________________________________________

Note: Picture of students at work. Photos must show students are working. Formal shots and NO wacky shots. Place a
description of the task that the student is performing.

ILLUSTRATIONS OF ACTIVITIES PERFORMED

(DAILY ACTIVITY LOG)

Day ___

_________________________________________________________

_________________________________________________________

_________________________________________________________
 Day ___

_________________________________________________________

_________________________________________________________

_________________________________________________________

Note: Picture of students at work. Photos must show students are working. Formal shots and NO wacky shots. Place a
description of the task that the student is performing.

ILLUSTRATIONS OF ACTIVITIES PERFORMED

(DAILY ACTIVITY LOG)

Day ___

_________________________________________________________

_________________________________________________________

_________________________________________________________
 Day ___

_________________________________________________________

_________________________________________________________

_________________________________________________________

Note: Picture of students at work. Photos must show students are working. Formal shots and NO wacky shots. Place a
description of the task that the student is performing.

ILLUSTRATIONS OF ACTIVITIES PERFORMED

(DAILY ACTIVITY LOG)

Day ___

_________________________________________________________

_________________________________________________________

_________________________________________________________
 Day ___

_________________________________________________________

_________________________________________________________

_________________________________________________________

Note: Picture of outputs done at work with description. Students may not need to be included in the photo. Add more
boxes if necessary.

SAMPLE OUTPUTS AT WORK SITE

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_________________________________________________________

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SAMPLE OUTPUTS AT WORK SITE

_________________________________________________________

_________________________________________________________

_________________________________________________________

Summarize activities performed and learned from the weekly diary

Include new skills / knowledge acquired during the training
Issues encountered / corresponding solutions
*150 words and above, Computer print outs.

NARRATIVE SUMMARY OF WORK IMMERSION

Note: Picture of students at work. Photos must show students are working. Formal shots and NO wacky shots. Select at
least 4 from the Illustrations of Activities Performed.

WORK IMMERSION HIGHLIGHTS

(Photos at work with Description of learnings from this activity)

Learnings (Written): _________________________________________

 _________________________________________________________

_________________________________________________________

Learnings (Written): _________________________________________

_________________________________________________________

_________________________________________________________

Note: Picture of students at work. Photos must show students are working. Formal shots and NO wacky shots. Select at
least 4 from the Illustrations of Activities Performed.

WORK IMMERSION HIGHLIGHTS

(Photos at work with Description of learnings from this activity)
Learnings (Written): _________________________________________

_________________________________________________________

_________________________________________________________

Learnings (Written): _________________________________________

_________________________________________________________

_________________________________________________________

Note: Include Photocopy of Certificate of Completion and Photocopy of Daily Time Record Card

OTHER RELEVANT PICTURES/DOCUMENTS

Note: Include Photocopy of Certificate of Completion and Photocopy of Daily Time Record Card

OTHER RELEVANT PICTURES/DOCUMENTS

 REFLECTIONS
(SWOT ANALYSIS)
STRENGTH:
Strength gained during the training
Strength observed by superior during training
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
____________________

_____________________________________________________________________

WEAKNESSES:
Weakness addressed / observed during the training

________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
____________________

_____________________________________________________________________

OPPORTUNITIES:
Opportunities encountered in the industry / company for individual growth

________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
____________________

_____________________________________________________________________

THREATS:
Threats encountered against strength
Threats that expose weaknesses

________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
____________________

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Note: Montage of Photos at Work Immersion. Student can freely choice their style of arrangement

PHOTO GALLERY