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01 Application For Internship

The document is an application for a 240 hour internship submitted by Kyle Bryan Ysit, a 21 year old single male studying BS Mechanical Engineering. He is applying to do his internship at Barangay Machine Works in Dagupan City under the supervision of Manuel A. Ventura, requiring certification that he is physically and mentally fit. The application requires signatures from instructors, coordinators, department chairs, and the campus executive director to approve the internship placement.

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Christopher Ysit
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65 views1 page

01 Application For Internship

The document is an application for a 240 hour internship submitted by Kyle Bryan Ysit, a 21 year old single male studying BS Mechanical Engineering. He is applying to do his internship at Barangay Machine Works in Dagupan City under the supervision of Manuel A. Ventura, requiring certification that he is physically and mentally fit. The application requires signatures from instructors, coordinators, department chairs, and the campus executive director to approve the internship placement.

Uploaded by

Christopher Ysit
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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FM-AA-INT-01

Rev. 0
03-Oct-2017

APPLICATION FOR INTERNSHIP


PANGASINAN STATE UNIVERSITY

A. PERSONAL PROFILE
NAME Ysit Kyle Bryan Blance
Surname Given Name Middle Name

AGE 21 CIVIL STATUS Single


SEX Male CONTACT NUMBER 09611449269
COURSE BS Mechanical Engineering YEAR & SECTION BSME V
MAJOR N/A PARENT/GUARDIAN Rosie B. Ysit.
CURRENT ADDRESS Del Prado Village Poblacion, Urdaneta City, Pangasinan
HOME ADDRESS Del Prado Village Poblacion, Urdaneta City, Pangasinan
B. ACADEMIC CREDENTIALS/QUALIFICATIONS

This is to certify that as per records kept in this office, the above name had already taken and pass ______ units except the following subject/s to wit:

SEM SY SUBJECT PASSING FAILING GRADE SIGNATURE DATE

This is to certify that he/she is Fernando G. Servitillo III to undergo internship.

Certified and verified true and correct:

_________________________
Registrar

C. FIRM/AGENCY/COMPANY FOR INTERNSHIP


NAME OF THE
FIRM/AGENCY/COMPANY Barangay Machine Works
ADDRESS # 0543 Mc. Arthur Highway, Carangalan Dagupan City, Pangasinan
HEAD Manuel A. Ventura
CONTACT NUMBER 0908-876-0320
NUMBER OF HOURS 240
Note: Please attach Medical Certificate and Psychological Test from any government physician, certifying that the student applicant is physically,
emotionally, and mentally fit for the internship training activity.

RECOMMENDING APPROVAL

Internship/Practicum Subject Instructor Campus Internship Coordinator

Program Chair College Dean

APPROVED BY:

__________ ___________
Campus Executive Director

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