Republic of the Philippines

North Eastern Mindanao State University

Cantilan, Surigao del Sur

OJT PLACEMENT OFFICE

Telephone # (086) 212 - 5322

Date: February 12, 2024

JSINSP VINCENT JOMINI Q. ORCULLO

Bislig City Jail Female Dormitory
Bislig City

Dear Sir/Madam:

I am Irish A. Encendencia, a fourth-year BS Criminology student at NEMSU Cantilan College of

Criminal Justice Education. As part of the course requirements, we are mandated to undergo one hundred
eighty hours (180) hours per bureau with a minimum total of five hundred forty (540) hours of On-the-Job
Training.
I am applying to your bureau as a trainee with the belief that the experience I will gain can
significantly enhance my skills and provide additional knowledge relevant to my chosen field of study.

I am hopeful for your favorable response to this application.

Thank you, and God bless!

Very truly yours,

IRISH A. ENCENDENCIA
On – the – Job Trainee
Endorsed:

GERALDINE V. DARAO, PhD JOSEPHINE A. BASADRE, MBA

OJT Program Coordinator, CCJE OJT Placement Coordinator

LAURENCE P. BAZAN, PhD MYRNA S. LOREN, MAEd

Dean, College of Criminal Justice Education Head, Student Affairs & Services

ROZETTE E. MERCADO, PhD

Asst. Campus Director

JUANCHO A. INTANO, PhD

Campus Director

OJT LIABILITY WAIVER

This On-the-Job Training Consent/Waiver, executed by Irish A. Encendencia of NEMSU Cantilan College of
Criminal Justice Education, a Filipino and a resident at P-1 Bucac Bayugan City, Agusan del Sur hereinafter
referred to as the On-the-Job Trainee, pertains to any government offices/agencies.

WHEREAS, NEMSU Cantilan College of Criminal Justice Education, the university where the On-the-Job
Trainee is a student, has requested the bureaus for the On-the-Job Trainee to undergo training for a minimum of five
hundred forty (540) hours as part of academic requirements for graduation. As a graduating student, I hereby declare
and state the following:

1. During the period of On-the-Job Training, with due diligence and good faith, the On-the-Job Trainee shall
abide by all rules and regulations observed by the agencies/offices.
2. The agencies/offices shall not be held liable for any injury/accident that the On-the-Job Trainee may suffer in
the course of his/her training.
3. The bureau shall not be held liable for damage or injury to a third person caused by the trainee, which is due
to his/her intentional/negligent act.
4. It is clearly understood that during the period of his/her training and presence in the bureau, no employer-
employee relationship exists between the On-the-Job Trainee and the bureau.

Signed on this __ day of ___________ 2024 at NEMSU Cantilan – Campus, Cantilan, Surigao del Sur,
PHILIPPINES."
 Republic of the Philippines
North Eastern Mindanao State University
Cantilan, Surigao del Sur

OJT PLACEMENT OFFICE

Telephone # (086) 212 - 5322

IRISH A. ENCENDENCIA MA.GLENDA A. ENCENDENCIA

Signature Over Printed Name of Trainee Signature Over Printed Name of Parent/Guardian

MYRNA S. LOREN, MAEd _____________________________________

Head, Student Affairs & Services Signature Over Printed Name of Head of Bureau

JOSEPHINE A. BASADRE, MBA LAURENCE P. BAZAN, PhD

OJT Placement Coordinator Signature Over Printed Name of Dean

JUANCHO A. INTANO, PhD

Campus Director
___________________________________________________________________________________
SUBSCRIBED AND SWORN TO BEFORE ME this ___ day of _____________ at _______________, Philippines, is
the agreement presented and shown to me, along with their Residence Certificate No. 27864584 and 27822811 respectively.

Doc. No.____
Page no.____
Book no.____
Series of 2024

PARENTAL CONSENT
KNOW ALL MEN BY THESE PRESENT:

I, Mr./Mrs. Ma.Glenda A. Encendencia, a resident with a postal address at P-1 Bucac

Bayugan City, Agusan del Sur, Philippines, having been duly informed regarding the deployment of
Criminology OJT/interns in various bureaus of the government sectors bounded by a Memorandum
of Agreement (MOA) which will start from February 12, 2024 to March 13, 2024, as a requirement
for their On-the-Job Training, do hereby give my consent to my son/daughter Irish A. Encendencia
who shall be under the direct supervision of the OJT Program Coordinator and OJT Placement
Coordinator.

With all the benefits that our son/daughter could derive from this On-the-Job Training, I
shall not hold the party concerned (bureau, university, coordinators, government personnel) where
my son/daughter is assigned responsible for any incident that may happen beyond their control.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of _________________,
2024, at Cantilan, Surigao del Sur, Philippines.

IRISH A. ENCENDENCIA
Signature Over Printed Name of Student Trainee

Res. Cert. No. : 27864584

Issued at : Bayugan City, ADS.
Issued on : January 26, 2024
With our consent and approval:

MA.GLENDA A. ENCENDENCIA JUANCHO A. INTANO, PhD

Signature Over Printed Name of Parent/Guardian Campus Director
Res. Cert. No. : 27822811
Res. Cert. No. : 27864584
Issued at : Bayugan City,ADS
Issued at : Bayugan City , ADS.
Issued on : January 26, 2024 Issued on : January 04, 2024

SUBSCRIBED AND SWORN BEFORE ME this ___day of _____________at _______________, Philippines the
agreement existing and shown to me with Residence Certificate No. 27864584 and 27822811 respectively.

Doc. No.____
Page no.____
Book no.____
Series of 2024
 Republic of the Philippines
North Eastern Mindanao State University
Cantilan, Surigao del Sur

OJT PLACEMENT OFFICE

Telephone # (086) 212 - 5322

PERSONAL DATA SHEET

PERSONAL INFORMATION
Name : Irish A. Encendencia
Civil Status : Single
Permanent :
P-1 Bucac Bayugan City, Agusan del Sur 2x2 pic
Address
Birth Date : October 11,2001
Birth Place : Butuan City Contact Number : 09382551285
Nationality : Filipino
Age : 22
Sex : Female Height : 157cm Weight : 54 kg.

FAMILY BACKGROUND
Father : Julius C. Encendencia Occupation : Businessman
Mother : Ma. Glenda A. Encendencia Occupation : Businesswoman
Address : Bayugan City Agusan del Sur Contact No. : 09100232667

EDUCATIONAL BACKGROUND
Elementary : East Bayugan Central Elementary School School Year : 2013-2014
Secondary : BayuganNationalComprehensiveHigh School School Year : 2019-2020
Tertiary : NEMSU
Course : Bachelor of Science in Criminology Major :
OJT Program : Geraldine V. Darao, PhD
Coordinator

CHARACTER REFERENCES
Name Position Address
Juancho A. Intano, PhD Campus Director NEMSU-Cantilan Campus
Laurence P. Bazan, PhD Dean, CCJE NEMSU-Cantilan Campus
Josephine A. Basadre, MBA OJTPlacement Coordinator NEMSU-Cantilan Campus

I hereby certify that the above information is true and correct to the best of my knowledge
Res. Cert. : 27864584
No.
Issued at : Bayugan City, ADS
Irish A. Encendencia
Issued on : January 26, 2024
Student Trainee
 Republic of the Philippines
North Eastern Mindanao State University
Cantilan, Surigao del Sur

OJT PLACEMENT OFFICE

Telephone # (086) 212 - 5322

Res. Cert. No. : 27822811 OJT ACCEPTANCE FORM

Issued at : Bayugan City, ADS
Issued on : January 04, 2024
______________________
Date

This confirms the acceptance of IRISH A. ENCENDENCIA as an On-the-Job trainee in our bureau.
He/she will be provided with work exposure and full support in the assigned area. However, the bureau reserves
the right to discontinue the training of the above trainee if all the requirements set by the agency are not met.

The details of his/her On-the-Job training are as follows:

Name of Bureau: ________________________________________

Unit/Department Assignment: ________________________________________
Unit/Department Head: ________________________________________
Office Address/Location: ________________________________________
Contact Details: ________________________________________

OJT Starts On: ________________________________________

OJT Ends On: ________________________________________
OJT’s required No. of Hours: ________________________________________
OJT Reporting Time: ________________________________________

Respectfully yours,

________________________________ Conforme:
(Bureau Representative)
Signature over printed name
________________________________ Irish A. Encendencia
(Position) (Student Trainee)
Signature over printed name
________________________________
(Department)
________________________________
(Contact No./Email Add)
EVALUATION FORM
BUREAU CONTACT INFORMATION
Bureau Name: _____________________________________ Head of Bureau: _________________________
Bureau Address: ________________________________ Position: _______________________________
______________________________________________ Cell/Tel. No.:____________________________
__________________________________________________________________________________________________________
OJT/INTERN INFORMATION
OJT Name: Irish A. Encendencia Date Started: _________________________
Course/Year: BS Criminology Date Ended: __________________________
Mobile No.:09093261080 Total Training Hours.: 540 hours
Part 1: (Please complete the evaluation of the intern for each period. Please be as accurate as possible in evaluating the interns progress. Kindly check the
__________________________________________________________________________________________________________
appropriate rating box for each item)

RATING
COMPETENCY Range Percentage
Rating Scale Interpretation
Value Equivalent
1. Ability to Learn
2. Acceptance of direction and responsibility
3. Adaptability
4. Appearance/Hygiene
5. Meetings of deadlines
6. Moral and Ethical Values
 Republic of the Philippines
North Eastern Mindanao State University
Cantilan, Surigao del Sur

OJT PLACEMENT OFFICE

Telephone # (086) 212 - 5322

7. Motivation and Initiative

8. Observe Courtesy/Uprightness
9. Punctuality and Attendance
10. Quality and Accuracy of Work
11. Safety Practices
12. Sensitivity and Concern for Others
OVERALL RATING

SUMMARY: Rating Scale Range Value Percentage Equivalent Interpretation

5 4.3 – 5.0 96 – 100 Excellent
4 3.5 – 4.2 91 – 95 Very Good
3 2.7 – 3.4 86 – 90 Good
2 1.9 – 2.6 81 – 85 Marginal
1 1.0 – 1.8 80 below Poor

Strengths/Weaknesses (if any): __________________________________________________________________________________

__________________________________________________________________________________________________________
Comments/Suggestions/Recommendations: _____________________________________________________________________
__________________________________________________________________________________________________________

Signature over Printed Name of Evaluator Signature over Printed Name of Bureau Head
__________________________________________ _______________________________________________
Name & Signature Name & Signature
______________________________________________ ___________________________________________
Position Position
______________________________________________ ____________________________________________________
Date Date

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