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:____________
INTERNSHIP AGREEMENT
_______________________________ ________________________________
Company Representative Student Intern
Date Signed: _____________________ Date Signed: _____________________
CTC/ID Number: __________________ CTC/ID Number: __________________
Issued at: ______________________ Issued at: ______________________
Issued on: ______________________ Issued on: ______________________
With our Consent & Approval:
Witnesses:
___________________________
Engr. Dana Camille G. Dioquino Engr. RUFO D. DURIAN
ILDO, Engineering Program Dean - Engineering
Before me, a Notary Public, this ______ day of _____________ 2019, personally appeared :
Student Intern
Known to me and to me known to be the same persons who executed the foregoing
instrument and acknowledged to me the same to be their free and voluntary act and deed amd that of
the institutions they represent.
This instrument consisting of 2 pages including the page on which the acknowledgement is
written, has been signed on the left margin of each and every page thereof by the parties.
______________________________
Notary Public
Doc. No.: ________________
Page No.: ________________
Book No.: ________________
Series of 2019