PART III: FORMS

CEBU TECHNOLOGICAL UNIVERSITY

ON-THE-JOB TRAINEE INFORMATION SHEET

A.PERSONAL DATA

2”x2” Photo

First Name: JorenLast Nane: GalanidaMiddle Name: LumanogCourse,Major, Yr& Sec. BSME, Major in Machine Shop, IV-AGender: ( √ ) Male (__)Female Age:

Current Address:Provincial Address:Tel. No.: Mobile No.:Birth Date: Birth Place:Civil Status: Religion:Citizenship: Email Address:

B. FAMILY DATAFather: Occupation:Mother: Occupation:

C. HEALTH DATABlood Type: Weight:Height: Health Problems:

D. SCHOLASTIC DATAPARTICULAR COLLEGE VOCATIONAL SECONDARY

School: Cebu Technological University Cebu Technological UniversityAddress: R. Palma St., Corner M.J.

Cuenco Avenue, Cebu CityR. Palma St., Corner M.J.

Cuenco Avenue, Cebu CityYear Graduated: 2011-present 2013-2014 2010-2011Honors/Awards Received: - - -

E. WORK EXPERIENCESPOSITION INCLUSIVE DATE COMPANY ADDRESS

F. SPECIAL SKILLS

G. CHARACTER REFERENCES (not related to you)Name Position Address Contact No.

H. INCASE OF EMERGENCY, PLEASE NOTIFY:Name Address Contact No.

I HEREBY CERTIFY that the above informationComm. Tax Cert. No.: is true and correct to the best of my knowledge Issued At: and belief.Issued On:

Signature of Student-Trainee

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OJT Form 1October 2012Revision: 0

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