Industrial Relations and Job Placement Office

PERSONAL DATA FORM

(For Supervised Industrial Training)

Full Name: Justin Lorenz B. Quinicot

Course / Section: TO4-B Contact Number: 09496462569
Complete Address: Matagoy Olaybar St. Silay City Negros Occidental 6116
Email Address: justinlorenzquinicot@gmail.comStudent I.D. No.: 2012-12-388
Parent's Name: Vicente V. Quinicot___________________________________
Parent's Address: Matagoy Olaybar St. Silay City, Negros Occ. 6116_____________
Contact Number: 09062739251 /09333162996___________________________
OTHERS:
Date of Birth: 11/25/1992 Place of Birth: Silay City _
Sex: __M F
Civil Status:
Single _ Religion: Roman Catholic Height: 1.72 m Weight: 110 kg
EDUCATIONAL BACKGROUND:
Name of School
Address:
Inclusive Dates
St. Theresita's Academy _ Rizal St. Silay City Negros Occ. 6116 __1999 - 2005__
Don Bosco Technical Institute VMC, Victorias City Negros Occ__
2005 - 2009__
TUP - Visayas________
Capt. Sabi St. Talisay City Negros Occ._ 2009 - present
SKILLS / ACHIEVEMENTS:
Computer Technician (Hardware ,Software and Networking) ,CAD Operator (Electrical
2D Designs) , LPG Refiller , Quality Control Inspector (LPG & Acetylene Plant) ____
SPECIAL TRAINING / SEMINARS ATTENDED:
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SUPERVISED INDUSTRIAL TRAINING ATTENDED:
Name of Company
Pryce Gases Inc.
_
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____________________
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Company Address:
Inclusive Dates
Luguay, Silay City Negros Occ__ April 2012 - June 2012
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I certify that the above information are true.

STUDENT SIGNATURE: _______________________ _ Date: _________ __ _

PARENTS SIGNATURE: _________________________ Date: ________________