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Witness
KNOW ALL MEN BY THESE PRESENTS:
Witness
The POLYTECHNIC UNIVERSITY OF THE
PHILIPPINES, a state university created and
organized under the laws of the Republic of the
Philippines, represented by its Vice President for
Witness
Academic Affairs, DR. MANUEL M. MUHI,
with principal address at Anonas Street, Sta.
Mesa, Manila, and hereinafter referred to as the
“FIRST PARTY”;
-and-
Witness
The DEPARTMENT OF EDUCATION, and
instrumentality of the National Government,
created and existing under the laws of Republic
of the Philippines, represented by the Schools
Division Superintendent of Pasig City, DR,
DOMINICO C. IDANAN, CESO VI, with
principal address at Caruncho Avenue, Metro
Department of Education
Manila, Pasig City, and hereinafter referred to as
WITNESSETH:
Witness
WHEREAS, both PARTIES believe that aside from the usual practice
teaching, intensive field study is necessary to adequately prepare the student teachers
for their functions and responsibilities;
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1. The FIRST PARTY shall:
1.1. Coordinate with the Schools Division Superintendent and the School
Head on the deployment of the Field Study Students (FSS)/Student
Teachers (ST);
1.2. Conduct regular supervisory visits during the stay of the FSS/ST in the
Witness
designated school;
1.3. Conduct exit conference with the cooperating school head; and
1.4. Gather feedback from the principal and the cooperating school
Department of Education
2. The SECOND PARTY shall:
2.2. Allow the FSS/ST to observe classes and school activities as required; a
minimum of seventeen (17) hours for FSS and not less than three
hundred (300) hours for ST;
2.4. Allow the FIRST PARTY to supervise the activities of their FSS/ST in
coordination with the department heads/grade level chairs/school heads;
Polytechnic University of the Philippines
2.5. Allow the FSS/ST access to school information for research and
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instructional purposes;
By: By:
______________________________ ____________________________
DR. MANUEL M. MUHI DR. DOMINICO C. IDANAN,
Vice President for Academic Affairs CESO VI
Schools Division Superintendent
of Pasig City
___________________________________ ____________________________
DR. MA. JUNITHESMER D. ROSALES MR. GILBERT O. INOCENCIO
Dean, College of Education Principal
___________________________________ _________________________________
DR. DENNIS O. DUMRIQUE MRS. CRISELDA B. DINGLE
Chairperson, Department of Business Department Head
Teacher Education
ACKNOWLEDGEMENT
BEFORE ME, a Notary Public, for and in the City of ___________, personally
appeared:
Proof of Identity
known to me to be the same persons who executed this instrument and acknowledged the
same as their free and voluntary act and deed and of the entities they respectively represent.
This document consists of three (3) pages including the page where this
Acknowledgement is written, and the parties and their instrumental witnesses signed at the
right margin of each and every page hereof.
WITNESS MY HAND AND SEAL on this _____ day of __________, 2018 in the
City of __________, Philippines.
NOTARY PUBLIC
Doc. No.: ___;
Page No.: ___;
Book No.:___;
Series of 2018.