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URDANETA CITY UNIVERSITY

College of Engineering and Architecture


San Vicente West, Urdaneta City 2428
Pangasinan, Philippines
Telefax No.: (6375) 568-7612
Telephone No.: (6375) 568-5062
Website: www.ucu.edu.ph

OJT CHECKLIST OF REQUIREMENTS

NAME: ______________________________ COURSE/ YR.: ______________


NAME OF COMPANY: ____________________________________________
COMPANY ADDRESS: ____________________________________________
CONTACT PERSON: _________________________ CELLPHONE NO.: _________________
POSITION: ________________________________ Tel/ FAX NO.: ____________________

Please submit the following documents for purposes of your On- The- Job training on or before
___________________. Provide two (2) copies in long folder each. (1 red folder & 1 white folder)

Resume with 2x2 photo


Birth certificate/ PSA
Evaluation Form
Application letter
Police clearance/ NBI clearance
Medical certificate (for Training Purposes Only)
Waiver (Signed by parents/guardian) & Affidavit of Consent of Parents and Student (notarized)
Recommendation letter from the College Dean
MOA (Memorandum of Agreement)
Immersion (Certificate)

DATE SUBMITTED: _____________________


REMARKS: ____________________________
Target Date of completion if there are incomplete documents: _________________

_________________________________
Student Name and Signature

Verified by:

_______________________ ________________
OJT Coordinator Date Verified

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