Name of Student School CHILDREN FIRST SCHOOL, INC. Track Grade and Section Immersion Site Strand/ Specialization Duration of Work Immersion School Partnerships Focal Person Work Immersion Teacher Contact Number RICHELLE APPLE M. RAYMUNDO 0945-098-9164 Contact Number LIST OF TASKS/ACTIVITIES Competencies Tasks/Activities Time Allotment Actual Schedule Remarks Students shall not be given other activities outside of those previously agreed upon, which are anchored on the stated competencies. Certified true and correct: ______________________________________ Student’s Signature Over Printed Name _______________________________________ Parent’s Signature Over Printed Name ______________________________________ Work Immersion Teacher’s Signature Over Printed Name _______________________________________ Industry Supervisor’s Signature Over Printed Name