' JA5 -AN2
SAMAR STATE UNIVERSITY - _
Catbalogan City, Snmar. 6700
OFFICE OF STUDENTINTERNSHIP PROGRAN
Undertaken at
Type the name of the Company here!
Presented to the Office of
Student Internship Program
In partial fulfillment of the requirements
for the Degree
Bachelor of Technology
Major: Food Technology
JUAN DELA CRUZ
Name of Student Trainee
School Year 2019-2020
SAMAR STATE UNIVERSITY
OFFICE OF STUDENT INTERNSHIP PROGRAM
Catbalogan City, Samar
TABLE OF CONTENTS
Pages
I. Title Page 1
II. Table of Contents. 2
III. Acknowledgement. 3
IV. Introduction. 4
V. My Preparation for Internship. . 5
VI. Company Profile. . 6
• Front picture of the company (with caption below for the .
complete address/Company contact numbers)
• History of the company. .
• Company Vision and Mission.
• Company Organizational Chart. .
VII. Narrative Report. .
• Narrative Report on Weekly Activities
VIII. Pictorials with Caption.
• Pictorials Working on Duty
• Pictorials with co-worker
• Pictorials with the Supervisor
IX. Conclusions. .
x. Recommendations.
• Potential of the Company as a Training Ground.
• Availability and appropriateness of facilities, tools,
machinery and Equipment.. .
• Company Personnel Cooperation with the trainee
• Proposed Revisions for the Improvement of the
SSU OJT Training Program (Advice to Future Student-Trainee).
XI. Appendices. .
A. Student Intern Personal Information.
B. SSU-SIP-FR-002.
c. SSU- SIP -FR-003. .
D. SSU- SIP -FR-004
E. SSU- SIP -FR-005. .
F. SSU- SIP -FR-006 (attached Daily Time Record or DTR's per month).
G. SSU- SIP -FR-007.
H. SSU- SIP -FR-008.
CERTIFICATE OF COMPLETION (duly signed by Supervisor/Manager).
J. SSU- SIP -FR-009 (signed by the manager/representative/Notarized.
Page 2
SAMAR STATE UNIVERSITY _
OFFICE OF STUDENT INTERNSHIP
PROGRAM
III. Acknowledgement
REMEMBER!!!
USE THE FOLLOWING REQUIREMENTS FOR ENCODING:
FONT: FONT SIZE:ARIAL 11
LINE SPACING: PAPER
1.5 SIZE:
A4
DELETE ME AFTER READING!!
Page 3
SAMAR STATE UNIVERSITY
OFFICE OF STUDENT INTERNSHIP
PROGRAM
IV. Introduction
Page 4 of
SAMAR STATE UNIVERSITY
OFFICE OF STUDENT INTERNSHIP
PROGRAM
V. My Preparation for Internship
Page 5 of
SAMAR STATE UNIVERSITY
OFFICE OF STUDENT INTERNSHIP
PROGRAM
VI. Company Profile
• Front picture of the company (with caption below for the complete address
/Company contact numbers and name of contact Person )
• History of the company
• Company Vision and Mission
• Company Organizational Chart
Page 6 of
SAMAR STATE UNIVERSITY
OFFICE OF STUDENT INTERNSHIP
PROGRAM
VI. Narrative Report
Narrative Report on Weekly Activities
Week 1April 2 — 6, 201940 hours
Discuss/Narrate here in paragraph form all the specific
activities/jobs/assignment/experiences you have done for the whole week. (2 weeks per
page and 50 words minimum)
REMEMBER!!!
USE THE FOLLOWING REQUIREMENTS
FOR ENCODING:
FONT: ARIAL
FONT SIZE: 11
LINE SPACING: 1.5
PAPER SIZE: A4
DELETE ME AFTER READING!!
Week 2April 9 — 13, 201940 hours
Page 7 of
SAMAR STATE UNIVERSITY
OFFICE OF STUDENT INTERNSHIP
PROGRAM
Week 3April 20 — 24, 201940 hours
Week 4April 25 — 29, 201740 hours
Page 8 of
SAMAR STATE UNIVERSITY
OFFICE OF STUDENT INTERNSHIP
PROGRAM
Week 5April 30 — May 4, 201740 hours
Week 6 May 5 — 9, 2017 40 hours
Continue below to complete your number of hours per week.. (delete me after reading)
Page 9 of
SAMAR STATE UNIVERSITY
OFFICE OF STUDENT INTERNSHIP
PROGRAM
VII. Pictorials with Caption
• Pictorials Working on Duty ( at least 2 pictures/ one page)
• Pictorials with the co-worker ( at least 2 pictures/ one page)
• Pictorials with the Supervisor ( at least 2 pictures/one page)
Page 10 of
SAMAR STATE UNIVERSITY
OFFICE OF STUDENT INTERNSHIP
PROGRAM
VIII. Conclusions
Page 11 of
SAMAR STATE UNIVERSITY
OFFICE OF STUDENT INTERNSHIP
PROGRAM
IX. Recommendations
• Potential of the Company as a Traininq Ground
• Availability and Appropriateness of facilities, tools, machinery and Equipment.
• Company Personnel Cooperation
Page 12 of
SAMAR STATE UNIVERSITY
OFFICE OF STUDENT INTERNSHIP
PROGRAM
• Proposed Revisions for the Improvement of the SSU -Internship
Program (Advise to Future Student Interns)
Page :I3 oj'16
SAMAR STATE UNIVERSITY
OFFICE OF STUDENT INTERNSHIP
PROGRAM
ASSESSMENT OF HOST TRAINING ESTABLISHMENT BY STUDENT INTERN
Month , 20
Name of Student Intern (optional):
Name of Establishment:
Place/Area of Assignment:
The purpose of this form is to provide the University with feedback on the
effectiveness of the Host Training Establishment in delivering its services to the student
interns. Please encircle your answer objectively and in all honesty. Rest assured that the
Office of Student Internship Program will observe strict confidentiality of your answers.
The assessment ratings range from 1 to 5 are as follows:
1 — Unsatisfactory (Never demonstrates this obligation/ responsibility)
2 — Needs Improvement (Seldom demonstrates this obligation
responsibility) 3 — Fair (Sometimes demonstrates this obligation
responsibility)
4 — Good (Usually demonstrate this obligation responsibility)
5 — Excellent (Always demonstrates this obligation/
responsibility) N/A — Not Applicable (Not applicable to this
internship experience)
No. Obligation/Responsibility Rating
Implements the internship plan in partnership with the
1 1 2 3 4 5 N/A
University at all times.
Encourages student intern to develop his/her personality and
2 professionalism, and, to the extent possible, protect him/her 1 2 3 4 5 N/A
from physical or moral danger.
The site supervisor exercises utmost responsibility in the 2 3 4 5 N/A
3
implementation of all internship phases.
Provides practical training or work experience in accordance
4 1 2 3 4 5 N/A
with the agreed internship plan and schedule of activities.
Ensures that student intern does not perform tasks and
5 1 2 3 4 5 N/A
duties of regular position in the agency/industry at all times.
Helps enhance the knowledge, skills, attitudes, and values of
6 1 2 3 4 5 N/A
the student intern.
Provides internship training in the form of actual exposure in
7
the various departments or units of the company.
Provides necessary incentives to the student intern such as:
(Please underline the incentive/s) free duty meals,
1 2 3 4 5 N/A
travel allowance, uniform, lodging, working hours, days
off, insurance. Others (please specify):
Provides harmonious relationship and comfortable 1 2 3 4 5 N/A
9
atmosphere.
10 Has working areas/sites conducive to learning/training. 1 2 3 4 5 N/A
Comments/Suggestions:
***Send/Hand this completed survey form to the Program Internship Coordinator./or
attached it in your narrative report*** Thank you.
SAMAR STATE UNIVERSITY
OFFICE OF STUDENT INTERNSHIP
PROGRAM
Page 14 of 16
SAMAR STATE UNIVERSITY
OFFICE OF STUDENT INTERNSHIP
PROGRAM
STUDENT INTERN PERSONAL INFORMATION
Name: Juan Dela Cruz Import ID picture
Address: Arteche Blvd. Barangay Guindapunan, Catbalogan here! !
City Mobile: 09176524422 / 09093456777
PERSONAL DATA
Age
Sex
Birthdate
Place of Birth
PARENTS INFORMATION OCCUPATION
Father
Mother
EDUCATIONAL BACKGROUND Year
Elementary
Secondary
College
College Course :
Major
Year & Section
INTERNSHIP TRAINING INFORMATION
Name of Company
Complete Address
Contact Number
Name of Supervisor Mobile Number
Total Training Hours
Dept. Section Assigned
Semester/School Year
JUAN DELA CRUZ
Student Intern/Signature
Page :I5 oj'
SAMAR STATE UNIVERSITY
OFFICE OF STUDENT INTERNSHIP
PROGRAM
APPENDICES
(Attached the following SIP Entry and Exit forms)
A. SSU-SIP-FR-002. Recommendation Letter
B. SSU- SIP -FR-003. Student Internship Curriculum Vitae
C. SSU- SIP -FR-004. On the Job Training Agreement
D. SSU- SIP -FR-005. Student Pledge and Waiver
E. SSU- SIP -FR-006. OJT Weekly Accomplishment Record Sheet
(Attached Daily Time Record or DTR's per month).
F. SSU- SIP -FR-007. Internship Evaluation Progress Report ( with rating)
G. SSU- SIP -FR-008. Internship Performance Assessment
H. SIP CERTIFICATE OF COMPLETION (From Company duly signed
by Supervisor/Manager)
1. SSU- SIP -009. Memorandum of Agreement (signed by the
manager/representative and DULY NOTARIZED)
Page :I6
