SIBALOM NATIONAL HIGH SCHOOL

SENIOR HIGH SCHOOL

Sibalom, Antique

Name: HENSCHIN CAMACHO

Track & Strand: INFORMATION AND COMMUNICATION TECHNOLOGY
Name of Work Immersion Partner: SKYE PRODUCTION
Duration: 80 HOURS
Immersion Teacher: MA. LOUELLA B. GAVAN

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 INSTRUCTIONS

This Journal is intended to serve as record of all accomplishments/tasks/activities

while undergoing training in the Immersion Partner. It will eventually become evidence

that can be submitted for portfolio assessment and for whatever purpose it will serve

you. It is therefore important that all its contents are viably entered by the trainee.

It is of great importance that the content should be written legibly on ink. Avoid any

corrections or erasures and maintain the cleanliness of this record. For accomplished

tasks, significant learning, problems encountered, etc. write in short sentences.

This will be submitted to Immersion Teacher and shall form part of the permanent

trainee’s document on file.

THANK YOU.

DUTIES & RESPONSIBILITIES

1. Attend Pre and Post Work Immersion activities.

2. Report to the Work Immersion Partner Institution during actual immersion with com-

plete number of hours.

3. Perform duties and tasks as indicated in the list of tasks/ activities.

4. Abide Work Immersion Partner policies and regulations.

5. Prepare documentations and reports required in the curriculum and by the Partner

Institution.

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Student’s Signature
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Name: ___________________________________________________________________________

Learner’s Reference Number (LRN): __________________________________________

Grade: _____________________ Strand: _____________________

Sex: _____________________ Religion: _____________________

Age: _____________________ Birthday: _____________________

Contact Number: ______________________________________

Place of Birth: ___________________________________________________________________

Permanent Address: ____________________________________________________________

Parent / Guardian: ______________________________________________________________

Address: ______________________________________________________________________

Contact Number: ______________________________________

Name of Work Immersion Partner: ___________________________________________

Address: ______________________________________________________________________

Direct Supervisor: ______________________________________________________________

Work Immersion Teacher: _____________________________________________________

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 BRIEF HISTORY OF WORK IMMERSION PARTNER

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 ACCOMPLISHMENTS

Day No.: __________ Date: _____________________________

IN: _________ OUT: __________
Accomplished Tasks:
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Supervisor’s signature

Day No.: __________ Date: _____________________________

IN: _________ OUT: __________
Accomplished Tasks:
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Supervisor’s signature

Day No.: __________ Date: _____________________________

IN: _________ OUT: __________
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Supervisor’s signature

Day No.: __________ Date: _____________________________

IN: _________ OUT: __________
Accomplished Tasks:
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Supervisor’s signature
 ACCOMPLISHMENTS

Day No.: __________ Date: _____________________________

IN: _________ OUT: __________
Accomplished Tasks:
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Supervisor’s signature

Day No.: __________ Date: _____________________________

IN: _________ OUT: __________
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Supervisor’s signature

Day No.: __________ Date: _____________________________

IN: _________ OUT: __________
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Supervisor’s signature

Day No.: __________ Date: _____________________________

IN: _________ OUT: __________
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Supervisor’s signature
 ACCOMPLISHMENTS

Day No.: __________ Date: _____________________________

IN: _________ OUT: __________
Accomplished Tasks:
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Supervisor’s signature

Day No.: __________ Date: _____________________________

IN: _________ OUT: __________
Accomplished Tasks:
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Supervisor’s signature

Day No.: __________ Date: _____________________________

IN: _________ OUT: __________
Accomplished Tasks:
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Supervisor’s signature

Day No.: __________ Date: _____________________________

IN: _________ OUT: __________
Accomplished Tasks:
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Supervisor’s signature
 PERFORMANCE VALUATION

TRAINEE’S PERFORMANCE EVALUATION

NOTE: Trainee’s evaluation is intended for Work Immersion Supervisors to use as a tool
for evaluating performance. Strictly DO NOT tamper or change any of the answers provid-
ed by the evaluator.

PART I. Rate student trainee according to over all performance. Mark check ( ) the box
that corresponds to your answer using the following rating scale.

Rating Scale:

4 – Very Good or Outstanding Performance (Performance exceeds the required stand-

ard)
3 – Good or Average Performance (Performance has met the required standard. Can
perform duties with minimal supervision)
2 – Fair Performance (Performance partially meets the required standard. Less than
satisfactory, could be doing better)
1 – Unsatisfactory or Poor Performance (Performance does not meet the required
standard. Major improvements needed)

A. Work Habits 4 3 2 1
1. Arrives early at work
2. Reports regularly
3. Performs tasks with less supervision
4. Practices self-discipline
5. Demonstrates dedication and commitment
Total

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B. Work Skills 4 3 2 1
1. Demonstrates the ability to operate machines needed on the job
2. Handles the details of the work assigned
3. Shows ability to multi task
4. Manifests thoroughness and precise attention to details
5. Comes up with good suggestions to problems
Total

C. Social Skills 4 3 2 1
1. Shows courtesy in dealing with different people
2. Offers help willingly
3. Learns from and listens to co-workers
4. Shows appreciation and gratitude for any help from others
5. Shows emotional maturity
Total

D. Professional Skills 4 3 2 1
1. Respects those in authority
2. Uses all tools, machines and work equipment responsibly
3. Follows all policies and procedures at work
4. Physical appearance is conducive to work environment
5. Observes proper dress code
Total

ACCUMULATED TOTAL

(continued to page 10)

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 EVALUATION

PART II. Write comments or suggestions for student trainee performance improvement, if
there is any.

A. Comments and Recommendations

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B. Acknowledgement of Performance Evaluation

I have read and discussed this appraisal with my supervisor and I understand its con-
tents. My signature means that I have been advised of my performance status and
acknowledge and agree with comments and recommendations .

Student’s signature:
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Date:
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Work Immersion Supervisor’s Signature over Printed Name:

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Date:
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 INSIGHTS

Day No.: _________________

Problem(s) Encountered: __________________________________________________________________________________________
How did you solve the problem if there was any? _______________________________________________________________
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Significant learning: ________________________________________________________________________________________________
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Day No.: _________________

Problem(s) Encountered: __________________________________________________________________________________________
How did you solve the problem if there was any? _______________________________________________________________
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Significant learning: ________________________________________________________________________________________________
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Day No.: _________________

Problem(s) Encountered: __________________________________________________________________________________________
How did you solve the problem if there was any? _______________________________________________________________
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Significant learning: ________________________________________________________________________________________________
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Day No.: _________________

Problem(s) Encountered: __________________________________________________________________________________________
How did you solve the problem if there was any? _______________________________________________________________
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Significant learning: ________________________________________________________________________________________________
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 INSIGHTS

Day No.: _________________

Problem(s) Encountered: __________________________________________________________________________________________
How did you solve the problem if there was any? _______________________________________________________________
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Significant learning: ________________________________________________________________________________________________
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Day No.: _________________

Problem(s) Encountered: __________________________________________________________________________________________
How did you solve the problem if there was any? _______________________________________________________________
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Significant learning: ________________________________________________________________________________________________
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Day No.: _________________

Problem(s) Encountered: __________________________________________________________________________________________
How did you solve the problem if there was any? _______________________________________________________________
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Significant learning: ________________________________________________________________________________________________
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Day No.: _________________

Problem(s) Encountered: __________________________________________________________________________________________
How did you solve the problem if there was any? _______________________________________________________________
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Significant learning: ________________________________________________________________________________________________
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 REFLECTIONS

My Reflections

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DOCUMENTATION

(Paste photo of work site and nonwritten output/ projects with captions)

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(Paste photo of work site and nonwritten output/ projects with captions)

(Provide separate sheet of paper if necessary.)

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 Sibalom National High School
SENIOR HIGH SCHOOL
Senior High School Offerings: FACULTY & STAFF
MRS. JANET G. ANIÑON, SSPI
SCHOOL HEAD

ACADEMIC TRACK: MR. JAYSON N. GILLESANIA

SHS COORDINATOR

HUMMS MR. ALLAN MONTENEGRO

ABM WORK IMMERSION FOCAL PERSON

IMMERSION TEACHERS:
MRS. MA. LOUELLA GAVAN
TVL TRACK: MRS. ROSLYN CEZAR
MRS. DARLENE JOY MENA
ICT MR. ALEXANDER ALERA
MR. JIMLIE NOCHE
SMAW MR. MARLON MUTAS

HE ADVISERS:
MRS. RAMONA ESTEVES
EIM MR. REMY ABONG
MRS. SWEET EVEROSE ESTRELLA
MR. JIMLIE NOCHE
MRS. JEANETH CERNA
MRS. JOANNA MARIE JABAGAT
MRS. JERALYN LAGONASO
MS. AILEEN BUTON
MR. ALJIM MILLAMENA

OTHER SUBJECT &

SPECIALIZATION TEACHERS:
MRS. MA. LOUELLA GAVAN (ICT)
MR. ALLAN MONTENEGRO (ICT)
MRS. ROSLYN CEZAR (HE)
MRS. DARLENE JOY MENA (HE)
MR. ALEXANDER ALERA (EIM)
MR. MARLON MUTAS (SMAW)
MR. SAMMY OBSIANA (SMAW)
MRS. JOSELITA PUYONG (ABM)
MS. ULOFFA MARIE MAGBANUA
MR. JAY SILVA
MR. JOHN PAOLO VENTURA
For enrolment inquiries, visit us at Barangay District 1,
KRISTINE ROSARIO DAGOHOY
Sibalom, Antique SHS ADMINISTRATIVE OFFICER
or follow us on our Facebook Pages:
MRS. LEIZL ABAD
www.facebook.com/sibalom.shs SHS REGISTRAR
www.facebook.com/SibalomNHS
REBECCA OTILANO
ADAS
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