Republic of the Philippines SOUTHERN LUZON STATE UNIVERSITY COLLEGE OF ENGINEERING Lucban, Quezon

APPLICATION FOR ON-THE JOB TRAINING Date: February 07, 2012 The Coordinator On-The-Job Training School of Engineering Sir/Maam: I wish to apply for placement in the On-The-Job Training Program. The following are my particular and preferences for your information and guidance. I. Personal Data Name: Jecyrill P. Cabangon Age: 24_______ Sex: F Civil Status: ______Single___________ Religion: Roman Catholic Home Address: 72 Florvill Ext. Delta Village Tandang Sora Quezon City

II.

Academic Data Major: Civil Year: Fourth Year

Course: _______Engineering________________ Subject Enrolled: CE Elective 1 Hydraulics (lecture) Hydraulics (laboratory Structural Theory 2 (lecture) Structural Theory 2 (laboratory) Structural Design 1 (Reinforced Concrete) lecture III. Preferences for Placement Company : Address : Contact Person : Position : Tel. Number : Fax Number :

Structural Design 1 (Reinforced Concrete) laboratory CE Laws Contracts Specifications & Ethics Hydrology Methods of Research

Equipments Engineers Inc. 12 Manggahan St., Quezon City 1110, Philippines Engr. Catalino Sebastian Construction Manager (63 2) 635 0843/ (63 2) 635 - 0851 (63 2) 635 - 0861

JECYRILL P. CABANGON__________ (Signature of Applicant over Printed Name) Recommending Approval:

_______________________________
ENGR. WINDA S. ELLAGA Department Head, Civil Engineering

Approved:
_____________________________________

Southern Luzon State University

ENGR, GERARDO B. GONZALES Dean, College of Engineering Southern Luzon State University