Polytechnic University of the Philippines

COLLEGE OF COMPUTER MANAGEMENT AND

INFORMATION TECHNOLOGY
Taguig Campus

INFORMATION SHEET OF TRAINING PARTNER

Training Partner
Address
Department/Section
Contact No.
Service Offered/Category
Contact Person
Cellphone No.

:
:
:
:
:
:
:

________________________________________________
________________________________________________
________________________________________________
_________________ Fax No.
: _________________
________________________________________________
________________________________________________
_________________ Email Add : _________________

______________________________________________________________________________
Training Supervisor
Contact No.
Cellphone No.

:
:
:

________________________________________________
_________________ Telefax
: _________________
_________________ Email Add : _________________

______________________________________________________________________________
Name of Trainee
Address
Department/Section
Contact No.
Cellphone No.

:
:
:
:
:

________________________________________________
________________________________________________
________________________________________________
_________________
_________________ Email Add : _________________

______________________________________________________________________________
Agreed Practicum Schedule :

Days: ________________

Time:

Date Started Practicum

Target Completion Date

:
:

__________________________
__________________________

Practicum Coordinator

__________________________

________________

Polytechnic University of the Philippines

COLLEGE OF COMPUTER MANAGEMENT AND
INFORMATION TECHNOLOGY
Taguig Campus

STUDENT INFORMATION SHEET

Student Number
Name

:
:

____________________
_____________________________________________________
Last
First
Middle

Gender
Civil Status
City Address

: ( ) Male
( ) Female
Nationality : ________________
: ( ) Single ( ) Married
: __________________________________________________________
______________________________________
Zip Code: ________

Provincial Address : __________________________________________________________

______________________________________
Zip Code: ________
Birthday
Telephone No.
E-mail Address
Skills

: ______________ Age : _____

Birthplace
: __________
: _______________________
Mobile Phone No. : __________
: _______________________
: __________________________________________________________
: __________________________________________________________

Information Technology/ Computer Science Subjects Completed:

First Year

Second Year

Third Year

RELATIVE in Case of Emergency

Name
Address

: ________________________________________________________________
: ________________________________________________________________
________________________________________________________________
Relationship : _________________________
Telephone No. : _____________________
Contact No. : ________________________________________________________________

PRACTICUM COORDINATOR COPY

Polytechnic University of the Philippines

COLLEGE OF COMPUTER MANAGEMENT AND
INFORMATION TECHNOLOGY
Taguig Campus

STUDENT INFORMATION SHEET

Student Number
Name

:
:

____________________
_____________________________________________________
Last
First
Middle

Gender
Civil Status
City Address

: ( ) Male
( ) Female
Nationality : ________________
: ( ) Single ( ) Married
: __________________________________________________________
______________________________________
Zip Code: ________

Provincial Address : __________________________________________________________

______________________________________
Zip Code: ________
Birthday
Telephone No.
E-mail Address
Skills

: ______________ Age : _____

Birthplace
: __________
: _______________________
Mobile Phone No. : __________
: _______________________
: __________________________________________________________
: __________________________________________________________

Information Technology/ Computer Science Subjects Completed:

First Year

Second Year

Third Year

RELATIVE in Case of Emergency

Name
Address

: ________________________________________________________________
: ________________________________________________________________
________________________________________________________________
Relationship : _________________________
Telephone No. : _____________________
Contact No. : ________________________________________________________________

TRAINING AGENCY SUPERVISOR COPY

Polytechnic University of the Philippines

COLLEGE OF COMPUTER MANAGEMENT AND
INFORMATION TECHNOLOGY
Taguig Campus

WEEKLY REPORT ON PRACTICUM ACTIVITIES

Practicum Student : _____________________________ Year and Section: ___________
Name of Training Partner : ____________________________________________________
Department/ Section
: ____________________________________________________
Training Supervisor
: ____________________________________________________
Date : ________________________
Time (In/ Out): ___________________________
Total no. of hours: _____________

Please classify each activity as Systems Analysis and Design (SAD), Programming, System
Maintenance, System Testing, Research, IT documentation, Web Design, Networking or Others.

DATE

__________________________
__________________________

ACTIVITIES

DESCRIPTION

Practicum Student Signature

Practicum Supervisor Signature
Polytechnic University of the Philippines
COLLEGE OF COMPUTER MANAGEMENT AND
INFORMATION TECHNOLOGY
Taguig Campus

Name of Practicum Student :

Name of Training Partner :
Department/ Section
:
Training Supervisor
:
Address
:
Position
:
Telephone Number
:

____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
_______________________

I. Basic Ability

ABILITY ITEM
Logical Thinking

Vitality
Leadership

Independence

Stability

Perseverance
Sociability

DESCRIPTION
Excel in the ability to build a concept
by analyzing, integrating, doing things
systematically, reasoning, and making
decisions.
Has the willingness to handle jobs
positively and vigorously; has energy.
Has the ability to motivate others to
cooperate towards a goal without
becoming uncongenial and negative to
his/her interpersonal communication.
Makes an effort to find a work to
confront problems even if no
instructions are received from other
people.
Has a sufficient knowledge of
etiquette and politeness and observe
certain moral and standards. Does not
openly show emotions related to
attitudes, feelings, or acts. An effort is
made to maintain a composed and
positive attitude towards work.
Has the persistency to complete tasks.
Associate well with people including
colleagues superiors, subordinates,
and customer personnel. Likes to
associate with people positively.

PERCENTAGE

Polytechnic University of the Philippines

COLLEGE OF COMPUTER MANAGEMENT AND
INFORMATION TECHNOLOGY
Taguig Campus

II. Business Processing Ability

ABILITY ITEM
Ability to plan

Ability to negotiate
Ability to document
Ability to communicate
Creativity

DESCRIPTION

PERCENTAGE

Always gathers information through various

channels; makes assessments of situations
changes and incorporates them into his/her
flexible planning.
Persuades others with confidence but
maintaining respect for the position of
negotiating party.
Write skillfully and concisely without
redundancy; difficult words in ambiguous
expressions are avoided.
Conveys his/her intentions to others; has a style
of narration which makes the other party at ease
and motivates them to act.
Continually proposes ideas that are not
conceived by other people.

III. Other Items for Consideration

A. Attendance

Always

Most of the Time

Seldom

1. Report for work on time

2. Works on time
3. Present during scheduled
dates
B. Jobs done by Practicum Student
_____________________________________________________________________________
_
_____________________________________________________________________________
_
_____________________________________________________________________________
_
_____________________________________________________________________________
_
C. Specify Practicum Students strengths and areas for professional growth.

_____________________________________________________________________________
_
_____________________________________________________________________________
_
_____________________________________________________________________________
_
_____________________________________________________________________________
_
____________________________________
Printed Name and Signature of Evaluator

______________________
Position

___________
Date

Polytechnic University of the Philippines

COLLEGE OF COMPUTER MANAGEMENT AND
INFORMATION TECHNOLOGY
Taguig Campus

Practicum Students Evaluation of Training Partner and Training Supervisor

Practicum Student
Training Partner/ Agency
Department/ Section
Training Supervisor
Rating Code:

:
:
:
:

_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

5 Strongly Agree
4 Agree
3 Neutral

2 Disagree
1 Strongly Disagree

1
1. The agency provided a favorable work experience
in accordance with the objectives set for the Practicum
Training Program
2. The agency recognizes the importance of the
Practicum training Program.
3. The agency created a climate conducive to learning
and facilitated the use of resources to help meet my
learning needs
4. The agency provides varied learning experiences for
me.
5. The agency usually incorporates ethical practice in
all their dealings.
6. I was assigned a competent training supervisor.
7. My training supervisor was effective in helping me
improve my IT and Communication Skills.

8. I was treated like a professional.

9. I would recommend this Training agency to others.
In the space below, write your important learnings and recommendations:

_____________________________________________________________________________
_
_____________________________________________________________________________
_
_____________________________________________________________________________
_
_____________________________________________________________________________
_
Signature: ______________________________

Date of Evaluation: ______________________