Republic of the Philippines

COTABATO CITY STATE POLYTECHNIC COLLEGE

College of Engineering, Technology and Computing
CIVIL ENGINEERING DEPARTMENT
Sinsuat Avenue, Cotabato City
Tel.No. (064) 552-1388

CERTIFICATE OF WAIVER

I, of legal age, Filipino, and a

resident of ___________________
after having been duly to in accordance with the law, do hereby depose
and say;
1. That I am presently studying BSCE, incoming 5TH year, at Cotabato City State
Polytechnic College, Cotabato City.
2. That, as part of BSCE curriculum requirements, I am required by the Civil Engineering
Department of the College of Engineering, Technology and Computing, Cotabato City
State Polytechnic College, the sending institution, to apply for On-Job-Training as Civil
Engineering Practicum (CE 510);
3. That I apply for the said On–Job–
Training/at____________________________________________________________
__________________________________________________________________
4. That I hereby waive that the above mentioned agency and the sending institution are
free from any liabilities arising from any untoward incident during the period of On-
Job-Training.
5. That I am executing this affidavit to attest to the truth of all the foregoing for whatever
legal intents and purposes this may serve.

IN WITNESS WHERE OF, I have here unto set my hand this day of
, Philippines.

Affiant Parent/Guardian

Republic of the Philippines)

City of Cotabato) S.S

SUBSCRIBED AND SWORN TO before me this day of 2019 at Cotabato

City, affiant appears me exhibiting to me his/her Community Tax Certificate No. ,
issued at Affixed my signature and seal this day above-written.

Doc. No.
Page. No.
Book. No.
Series. No. NOTARY PUBLIC
 Republic of the Philippines
COTABATO CITY STATE POLYTECHNIC COLLEGE
College of Engineering, Technology and Computing
CIVIL ENGINEERING DEPARTMENT
Sinsuat Avenue, Cotabato City
Tel.No. (064) 552-1388

PLEDGE

I , a bonafide resident of
, bind myself and promise:
1. To observe and abide by the laws of the land, the provisions of the conduct and
discipline, policies and regulation of ;
2. To abide the policies, rules and regulations of _______________
___________ which I have been accepted as an On-Job-Trainee;
3. To take utmost of property tools, equipment and
facilities made available to me during my training.
4. To observe at all time proper decorum and behavior expected of civilized and educated
person toward fellow trainees, authorities and personnel and to the public in general.

I hereby further blind myself to replace/repay the full or in part as may be required the
property lost or damaged through my own willful negligence and to face in full consequences
of my misbehavior or misconduct on my part.

__ __
Signature over Printed Name
Trainee

WITH MY KNOWLEDGE AND CONSENT:

Parent/Guardian

ON THE JOB TRAINING AGREEMENT

 Republic of the Philippines
COTABATO CITY STATE POLYTECHNIC COLLEGE
College of Engineering, Technology and Computing
CIVIL ENGINEERING DEPARTMENT
Sinsuat Avenue, Cotabato City
Tel.No. (064) 552-1388

The agrees to permit

to undergo on the job training for
the purpose of gaining experience, knowledge and skill in the various phases of this field of
study, In addition, it is agreed that:
1. The training program is designed to run for days or weeks
required for the works experience;
2. That trainee, while in the process of training will have the status of student-learning
neither displacing a regular worker now employed or substituting for a worker needed
by the cooperate;
3. The trainee agrees to perform diligently the work experience assigned to her/him. The
trainee also agrees to pursue faithfully the prescribed course of study and to take
advantage of every opportunity to improve his efficiency, knowledge and personal traits
so that he will be desirable employee at the termination of training period;
4. The company reserves the right to dismiss the trainee/student at any time for
misbehavior;
5. All complaints regarding the conduct and performance of the student-learner shall be
made to the parent/guardian and school;
6. The On-The-Job-Training of the student-learner shall conform to all laws and
regulations promulgated by duly constituted authorities.

The undersigned have thoroughly reviewed this document and hereby signify this
agreement to this provision.

_____________ _________________________________
Signature over Printed Name Signature over Printed Name
Trainee Agency/Company

Parent/Guardian
 Republic of the Philippines
COTABATO CITY STATE POLYTECHNIC COLLEGE
College of Engineering, Technology and Computing
CIVIL ENGINEERING DEPARTMENT
Sinsuat Avenue, Cotabato City
Tel.No. (064) 552-1388