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PART III: FORMS

CEBU TECHNOLOGICAL UNIVERSITY

OJT Form 1
October 2012
Revision: 0

ON-THE-JOB TRAINEE INFORMATION SHEET

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A.PERSONAL DATA
First Name:
Last Nane:
Middle Name:
Course,Major, Yr& Sec.
Gender:

Joren
Galanida
Lumanog
BSME, Major in Machine Shop, IV-A
Age:
( ) Male (__)Female

2x2 Photo

Current Address:
Provincial Address:
Tel. No.:
Birth Date:
Civil Status:
Citizenship:

Mobile No.:
Birth Place:
Religion:
Email Address:

B. FAMILY DATA
Father:
Mother:

Occupation:
Occupation:

C. HEALTH DATA
Blood Type:
Height:

Weight:
Health Problems:

D. SCHOLASTIC DATA
PARTICULAR
School:
Address:
Year Graduated:
Honors/Awards Received:

COLLEGE
Cebu Technological University
R. Palma St., Corner M.J.
Cuenco Avenue, Cebu City
2011-present
-

E. WORK EXPERIENCES
POSITION

INCLUSIVE DATE

VOCATIONAL
Cebu Technological University
R. Palma St., Corner M.J.
Cuenco Avenue, Cebu City
2013-2014
-

SECONDARY

2010-2011
-

COMPANY

ADDRESS

Address

Contact No.

F. SPECIAL SKILLS

G. CHARACTER REFERENCES (not related to you)


Name
Position

H. INCASE OF EMERGENCY, PLEASE NOTIFY:


Name

Comm. Tax Cert. No.:


Issued At:
Issued On:

Address

Contact No.

I HEREBY CERTIFY that the above information


is true and correct to the best of my knowledge
and belief.

Signature of Student-Trainee

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