1

FORM 1 – APPLICATION

BUKIDNON STATE UNIVERSITY

Accountancy Department
College of Business
Tel/Fax No. (088) 813-2717

I. General Information (Please print legibly in black ink. Answer all questions
completely.)

Name:
Current address:
Telephone/Cell number: Email address:

Office for which you wish to be considered(please indicate three in order of preference):

Name of Office Location Contact Person

II. Attach Student Grade Sheet (SGS)

III. Communication Skills

Please indicate by encircling at which level you rate your work performance skills
Writing Average Good Excellent
Reading Average Good Excellent
Listening Average Good Excellent
Oral Communication Average Good Excellent

III. Computer Skills

Please describe your computer skills and software knowledge.

Please list other relevant skills that you consider important for the internship(s) for
which you wish to be considered

IV. Experience
Please provide any paid or volunteer work experience that you consider important for
the internships(s) for which you wish to be considered (you may add more pages)

Name of Organization / Company

Organization Date
Job Title
Duties

V. References

Name
Position
Organization
Address
Telephone number E-mail address

I hereby certify that, to the best of my knowledge, all information contained in this
internship application is true and correct.

applicant’s signature/ date signed

 2

FORM 2- WAIVER

(School’s copy)

That we, ______________________________ and _____________________________ , both of

legal age, spouses, Filipino and residents of _______________________________________ ,
after being duly sworn to in accordance with the law hereby depose and say:
1. That we are parents of _______________________________________ (student’s name)
who is enrolled in Accounting117of the College of Business, Bukidnon State
University, Malaybalay City;
2. That our son/daughter is at present taking internship course as part of the
curriculum and is assigned to a public agency;
3. That as an intern, we are aware of the fact that our son/daughter may
discharge duties and responsibilities being part of their internship and as such
the school/agency is not liable in case of accident;
4. That we are therefore waiving any responsibility and/or liability of the school or
any of its authorities in the discharge of our son/daughter of their functions
and responsibilities.

IN WITNESS WHEREOF we have hereunto set our hands this ___ day of ____ , 20__

PARENT PARENT

(Student’s copy)

That we, ______________________________ and _____________________________ , both of

legal age, spouses, Filipino and residents of _______________________________________ ,
after being duly sworn to in accordance with the law hereby depose and say:
1. That we are parents of _______________________________________ (student’s name)
who is enrolled in Accounting 117 of the College of Business, Bukidnon State
University, Malaybalay City;
2. That our son/daughter is at present taking internship course as part of the
curriculum and is assigned to a public agency;
3. That as an intern, we are aware of the fact that our son/daughter may
discharge duties and responsibilities being part of their internship and as such
the school/agency is not liable in case of accident;
4. That we are therefore waiving any responsibility and/or liability of the school or
any of its authorities in the discharge of our son/daughter of their functions
and responsibilities.

IN WITNESS WHEREOF we have hereunto set our hands this ___ day of ____ , 20__

PARENT PARENT
 3

FORM 3- SAMPLE REQUEST LETTER FOR GROUP

BUKIDNON STATE UNIVERSITY

Malaybalay City, Bukidnon
8700 Telefax (088) 221 2237 Telefax (088) 813 2717
www.bsc.edu.ph buksucob.2016@gmail.com

ISO 9001 Certified

College of Business
ACCOUNTANCY DEPARTMENT

March 20, 2018

_________________
_________________
_________________

Sir:

Greetings of peace!

The Bachelor of Science in Accountancy (BSA) of the College of Business (COB), and
Bukidnon State University (BukSU) offers internship or on-the-job training (OJT) as part of the
curriculum. Its purpose is to enhance student’s knowledge in applying the theories learned in the
classroom to actual situations and to expose students to community service.

In this regard, may we humbly request your good office to collaborate with us in this noble
endeavor by accommodating the following students: Mr/Ms________________ who will do
his/her internship this summer. He/She will start his/her practicum on April_______ and is
expected to complete 600 hours.

Enclosed are copies of his/her resume’ and a sample certificate of acceptance for your perusal.

Thank you for your support and more power to you.

Very truly yours,

DR. NESTOR Y. CIPRIANO, CPA

Chair, Accountancy Department

NOTED:

DR. DEMETRIA MAY T. SANIEL

Dean, College of Business
 4

FORM 4- SAMPLE REQUEST LETTER FOR INDIVIDUAL

BUKIDNON STATE UNIVERSITY

Malaybalay City, Bukidnon
8700 Telefax (088) 221 2237 Telefax (088) 813 2717
www.bsc.edu.ph buksucob.2016@gmail.com
ISO 9001 Certified
College of Business
ACCOUNTANCY DEPARTMENT

March 20, 2018

_________________
_________________
_________________

Sir:

Greetings of peace!

The Bachelor of Science in Accountancy (BSA) of the College of Business (COB), and
Bukidnon State University (BukSU) offers internship or on-the-job training (OJT) as part of the
curriculum. Its purpose is to enhance student’s knowledge in applying the theories learned in the
classroom to actual situations and to expose students to community service.

In this regard, may we humbly request your good office to collaborate with us in this noble
endeavor by accommodating Mr/Ms________________ who will do his/her internship this
summer. He/She will start his/her practicum on April_______ and is expected to complete 600
hours.

Enclosed are copies of his/her resume’ and a sample certificate of acceptance for your perusal.

Thank you for your support and more power to you.

Very truly yours,

DR. NESTOR Y. CIPRIANO, CPA

Chair, Accountancy Department

NOTED:

DR. DEMETRIA MAY T. SANIEL

Dean, College of Business
 5

FORM 5 –RESUME’
JUAN A. DELA CRUZ
Picture
Kubayan, Malaybalay City
Cellphone Number 09123456345

PERSONAL DATA

Birthdate : April 1, 1998

Birthplace : Damilag, Manolo Fortich, Bukidnon
Gender : Male
Marital Status : Single
Height: : 5’5
Religion : Roman Catholic
Father’s name : Pedro C. dela Cruz
Occupation : Driver
Mother’s name : Juanita T. dela Cruz
Occupation : Housewife
Languages/
Dialects Spoken : English, Tagalog, Cebuano and Binukid

EDUCATIONAL ATTAINMENT

College : Bachelor of Public Administration (on-going)

Bukidnon State University
Malaybalay City, Bukidnon
(2013-present)

High School : Alae National High School

Alae, Manolo Fortich, Bukidnon
(2009- 2013)

Elementary : Damilag Elementary School

Damilag,Manolo Fortich, Bukidnon
(2003-2009)
SKILLS

Basic Computer Skills

MS Word
MS Excel and Power Point
Arts of Public Speaking (hosting, liaising)
Parliamentary Procedures Skills
Resolution and Ordinance Formulation
Basic Policy Analysis
Office Management Skills

REFERENCES

Engr. Pedro B. Bonifacio

Government Employee
Provincial Engineering Office
Provincial Government of Bukidnon
Malaybalay City, Bukidnon
Cel. Number 09123456789
Email add: perdoboni@gmail.com

Hon. Crisostomo V. Ibarra

Punong Barangay
Barangay Gwapo
Malaybalay City, Bukidnon
Cel. Number 09987654321
Email add: crisosibarra@gmail.com
 6

FORM 6- EMPLOYER INFORMATION FORM

BUKIDNON STATE UNIVERSITY

Malybalay City, Bukidnon
College of Business
Accountancy Department

EMPLOYER INFORMATION FORM

AGENCY/ ORGANIZATION INFORMATION

Agency/ Organization Name: Date
PHILIPPINE NATIONAL BANK- RIZAL BRANCH

Mailing Address:

City: Province
MALAYBALAY CITY BUKIDNON

Mr. Mrs. Ms. First Name Last Name

MARY JANE LIM

Job Title:
BRANCH MANAGER

Office # Cell Ph # (optional)

E-mail: Website Address: (if available)

STUDENT INTERN DETAILS

STUDENT INTERN’S NAME: Internship location (if Estimated Weekly work
different from above) hours:
MERAFEL CRIS B. MAQUE

Student will be an intern with us for the 1st 2nd Summer

following semester:

Intern Qualifications: Student will be using the following skills to complete the internship.

Written and verbal communication skills Organizational skills Presentation skills

Technical skills (pls. specify)
 7

FORM 7- STUDENT REPORT AND GOALS & LEARNING OBJECTIVES AGREEMENT

STUDENT INFORMATION
Complete ALL sections and submit to Internship Faculty Coordinator. (Please type or
print clearly)

Date: ID No. : 2129912 Gender FEMALE

Student’s Last First Middle

Name MAQUE MERAFEL CRIS BACALSO
Permanent
Address SAN VICTORES ST., PUROK 3, BARANGAY 9, MALAYBALAY CITY, BUKIDNON
City Address
Cell Number 09159535123 Birthdate JUNE 18, 1998
E-mail Ad crismaque78@gmail.com (month, date, year)

INTERNSHIP INFORMATION
(Please type or print clearly)

Agency Name PHILIPPINE NATIONAL BANK- RIZAL BRANCH

Supervisor Contact

Name: MARY JANE D. LIM Phone No.

Email Add: Fax No.
Website Address:
Address

Xxxxx -------------------------------------------------------------------------- xxxxx

GOALS AND LEARNING OBJECTIVES AGREEMENT

GOALS
 Provide training and experiential learning opportunities for the
development of my skills.
 Internship that will help me build professional network in the business
world.
LEARNING OBJECTIVES you aim to achieve
1. To be able to learn how a business works on both a large scale and on a
day-to-day basis.
2. To learn new skills.
3. To be able to learn things through doing, and asking constructive feedback
that will help me sharpen my skills and become more professional.
4. To be able to build my professional network.
 8

FORM 8 - SAMPLE CERTIFICATION OF ACCEPTANCE

(Date)

Dr. Nestor Y. Cipriano, CPA

Chairperson, Accountancy Department
Faculty Internship Coordinator
College of Business
Bukidnon State University

Dear Dr. Cipriano:

This confirms the acceptance of the following student/s as intern/s in our office.

Name of Intern:
Internship Period:
Unit / Division:
Expected Tasks/ Responsibilities:
Name of Supervisor:
Position and Contact Details of Supervisor:

As internship partner of the Accountancy Department, College of Business, Bukidnon

State University, we agree to abide by Internship Guidelines:

1. The internship program shall be for a minimum of 300 hours under

academic and professional supervision. The internship period shall begin on
April , 2018 and end no later than June ,2018.
2. The office shall ensure safe working condition on the intern.
3. The office shall allow the internship coordinator to observe the intern at work
and discuss with supervisor/mentor issues about the intern or the internship
program.
4. Upon completion of the internship, the office shall submit to Accoutancy
Department (a) a Certificate of Completion of Work Hours; (b) an Intern
Evaluation Form; and (c) the intern grade/s

We completely understand the internship guidelines. Any discussion pertaining to the

unbecoming performance of the intern, we will immediately inform your office in
writing.

(Name and Signature of the Office Head)

(Contact Details)
 9

FORM 9- MEMORANDUM OF UNDERSTANDING

Know all men by these presents:

This contract is entered into by and between the Accountancy Department, College of
Business, Bukidnon State University represented by Dr. Nestor Y. Cipriano,
Chairperson, Accountancy Department, of legal age, married, Filipino and resident of
Malaybalay City herein after called the PARTY OF THE FIRST PART and
City/Municipality of _________________, Bukidnon represented by ___________, likewise of
legal age, married, Filipino, and a resident of
___________________________________________, Bukidnon hereinafter called the PARTY OF
THE SECOND PART.

That the PARTY OF THE FIRST PART is an educational institution and requiring its
students to do practicum as a part of their curriculum while the PARTY OF THE
SECOND PART in which the latter accepts, under the following terms and conditions:

For the Student-Intern

1. Must have completed 60 units in Accountancy subjects.
2. Need to complete the 300 hours.
3. Wearing of practicum uniform and ID during office hours must be observed.
4. Observe proper behavior and office decorum.
5. Should report regularly and observe office hours.
6. Use DTR (Daily Time Record)/Bundy Card.
7. Should comply requirements given by the agency/office.
8. Submit Narrative Report.
9. Practicum is part of the curriculum.
10. In case of failure to comply the OJT policies, the student is disqualified to OJT.

For the Agency:

1. Evaluate the student’s performance by giving a grade ranging from 1.0-3.0.
2. Sign the student DTR and narrative reports.
3. Assign work to students related to their field of discipline.
4. Require students to follow office rules/ policies and standard operating procedures.
5. Refer/ confer with the practicum adviser on problems regarding practicum
students.

IN WITNESS WHEREOF, we have hereunto set our hands this _________day of ______,
20__ at Malaybalay City.

Accountancy Department City/Municipality of________

College of Business Bukidnon

By: By:
DR. NESTOR Y. CIPRIANO, CPA
Party of the first Part
Res. Certificate No._______
Issued at_________________
Issued on________________

Witnessed by: Witnessed by:

______________________________ ______________________________
Name, signature and date signed Name, signature and date signed

_____________________________ _____________________________
Position/ Designation Position/ Designation
 10

FORM 10- EVALUATION

BUKIDNON STATE UNIVERSITY

Malaybalay City Bukidnon
College of Business
Accountancy Department

SELF-EVALUATION

Student’s Name MERAFEL CRIS B. MAQUE Phone No. 0915-953-5123

Supervisor’s Name MARY JANE D. LIM Phone No.

Address
Agency Name PHILIPPNE NATIONAL BANK- RIZAL BRANCH

Internship Period: From APRIL 10, 2018 To JUNE , 2018

SELF EVALUATION: As mentioned before, the objective of this internship is to provide you as a
student with meaningful work assignments in a professional career field. Please use the following
scale to rate your work experience:
1= Unsatisfactory 2= Marginal 3= Average 4= Above Average 5= Outstanding

Ability to Learn: Clarity of directions from supervisor and other key persons.
1 2 3 4 5
Quality of Work: Quality of assignments given to you for this internship, and did you meet the
objectives.
1 2 3 4 5
Quantity of Work: Volume of Work assigned to you.
1 2 3 4 5
Communication: Ease of communication with supervisor and other key person
1 2 3 4 5
Relationship with others: Acceptance by co-workers at the internship site
1 2 3 4 5 NA
Attitude-application to work: how interesting and challenging was this internship?
1 2 3 4 5
Planning & Dependability: how effective were you in planning & coordinating your work, even in
the absence of direct supervision
1 2 3 4 5
Judgment: opportunity to analyze problems and make appropriate recommendations
1 2 3 4 5 NA
Attendance: your attendance to the established work schedule, or in keeping regular
communication with key contact.
1 2 3 4 5
Overall Performance: overall rating of your internship experience

1.0 1.25 1.50 1.75 2.0 2.25 2.50 2.75 3.0

Was this a Fulfilling internship experience and one that will help with your career preparation? ___
Do you plan to change your education curriculum (major or electives) as a result of your work
experience?___ Yes ____ No How?

Would you be willing to recommend this internship program to others?___ Why?

If this was a paid internship, how much were your paid per day?

Student’s Signature

Date
 11

FORM 11- AGENCY EVALUATION

BUKIDNON STATE UNIVERSITY

Malaybalay City, Bukidnon
College of Business
Accountancy Department

Name of Organization PHILIPPINE NATIONAL BANK- RIZAL BRANCH

Supervisor’s Name MARY JANE D. LIM Phone
Intern’s Name MERAFEL CRIS B. MAQUE
Internship Period (300 Hours) From APRIL 10, 2018 To JUNE , 2018
STUDENT EVALUATION: Please rate your intern OBJECTIVELY in each of the areas below using
the following rating
scale: 1 = Unsatisfactory 2 = marginal 3= average 4 = Above Average 5 = Outstanding
NA = Not applicable
Ability to Learn: How effective was the intern in understanding and following general instructions?
1 2 3 4 5
Technical aptitude: How effective was the intern in understanding the technical aspects of their
field, and relating that knowledge to their job?
1 2 3 4 5 NA
Quality of Work: quality of assigned work that the intern provided to you, and did the intern meet
the objectives?
1 2 3 4 5 Yes No
Communication: How effective was the intern in communicating both orally and in writing?
1 2 3 4 5
Relationship with others: How well did the intern work with other employees in your firm?
1 2 3 4 5 NA
Attitude-Application to work: How enthusiastic was the intern with this internship project?
1 2 3 4 5
Planning & Dependability : how effective was the intern in planning and coordinating his/her
work, and dependable in working steadily, even in the absence of direct supervision
1 2 3 4 5
Judgment: How well did the intern perform in analyzing problems and making appropriate
recommendations? or in formulating and advancing new plans, ideas, projects?
1 2 3 4 5 NA
Attendance: Rate the intern’s attendance to the established work schedule?
1 2 3 4 5
Promptness in reporting for work:
1 2 3 4 5 NA (virtual
internship)
Did the Student intern complete the required number of internship hours? (i.e., 320 hrs)
Yes No Comment:
Overall Performance: How well did the intern perform on this internship?
1.0 1.25 1.50 1.75 2.0 2.25 2.50 2.75 3.0

Has your organization previously used student interns from Bukidnon State University? ____
Would you be interested in continuing to participate in our internship program? _____
If yes, please indicate the semester you would like to recruit another intern?
1st sem 2nd sem Summer
Was there an opportunity to offer the student a full or part time job?
Yes No starting salary _______________
Would you be willing to recommend this type of program to other Yes No
Do you have any constructive criticism to offer regarding this student intern? Yes No
Please specify

Supervisor’s Signature / date signed

Thank you for completing this evaluation and participating in our internship program1 Please give
to your intern in sealed envelopes: one copy to Faculty Internship Coordinator.
 12

FORM 12- SAMPLE DAILY TIME RECORD

DAILY TIME RECORD

Name
For the month of 20
Official hours for arrival and departure
Regular Day:
Day A M P M Under
time
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31

I CERTIFY on my honor that the above is

true and correct report of the hours of worked/
performed, record of which was make daily at
the time of arrival and departure from office.

Signature

Verified as to the prescribed office hours

In- charge

FORM 13 - CERTIFICATION OF COMPLETION OF INTERNSHIP

(AGENCY/COMPANY HEADINGS)
 13

CERTIFICATION

This is to certify that _________________, a Bachelor of Accountancy

student of Bukidnon State University, Malaybalay City has rendered services in this
office as a student apprentice under the On-the-Job Training Program from the
period________________, 2018 to______________, 2018 with a total of 300 hours.

Given this _______ day of __________, 2017 at

________________________.

__________________________
Position
 14

FORM 14- WEEKLY JOURNAL

Name of Intern MERAFEL CRIS B. MAQUE

Agency/Address PHILIPPINE NATIONAL BANK- RIZAL BRANCH

WEEK DATES ACTIVITIES ASSIGNMENT/ ACCOMPLISHMENT

Week 1 APRIL  First week of

10- 13, internship

2018  Meeting the

people of the

organization

Week 2 APRIL  Scanning of

16- 19 transaction slips.

 Totaling the

statemet

Week 3

Week 4

Week 5

Week 6

Week 7

Week 8

Week 9

FORM 15 – SAMPLE THANK YOU LETTER

Date

Supervisor’s Name, Title

Organization’s Name
Address
 15

Sir/Madame:

As I conclude this internship, I want to let you know that it’s been a pleasure to work
with you and others at _______________________, your leadership, patience, and
enthusiasm made my internship experience a positive one. You’ve given me a great
opportunity to use my formal education in a real-world application,

I really appreciate the time you’ve taken to train and teach me new skills. Through this
internship I’ve also increased my knowledge in this area. In exchange, I hope I’ve been
a positive contribution to ___________________________.

During this last week I will be finalizing all details to my internship project. If there is
anything else I can assist you with before my last day here, please let me know. Once
again, thank you for this wonderful internship experience.

Very sincerely,

Intern’s Name
Address
Phone number

FORM 16- SURVEY QUESTIONAIRE

BUKIDNON STATE UNIVERSITY

Malaybalay City, Bukidnon
College of Business
Accountancy Department
 16

PROBLEMS ENCOUNTERED BY ACCOUNTANCY STUDENTS

Directions:

1. Rank the problems (A-F) according to scale 1-6 with 1 as less encountered and 6 as
most encountered.

2. Check the sub problems which you encountered during your practicum.

RANK PROBLEM

[1] A. FINANCIAL [ ]
1. Meal Allowance [ ]
2. Uniform for Practicum [ ]
3. Rental for Boarding House [ ]

[2] B. HUMAN RELATIONS [ ]

1. Relationship with Peers [ ]
2. Relationship with Employer [ ]
3. Relationship with Adviser [ ]

[3] C. REPORTS [ ]
1. Accessibility to Transportation [ ]
2. Assigned station is far from the campus [ ]

[4] E. COMPUTER SKILLS [ ]

1. Difficulty in making a report [ ]
2. Difficulty in meeting the deadline [ ]

[5] F. NATURE OF WORK/ASSIGNMENT [ ]

1. Not related to major subject [ ]
2. Assigned works are beyond their capacity to do [ ]

G. OTHER PROBLEMS

FORM 17- GRADE SHEET

BUKIDNON STATE UNIVERSITY

Malaybalay City, Bukidnon
College of Business
Accountancy Department

GRADE SHEET
 17

FULL NAME ATTENDANCE PERFORMANCE FINAL GRADE REMARKS

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

General Comments for the intern/s

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

GRADE DESCRIPTION

1.00 - Excellent
1.25 - Superior Rated by:
1.50 - Very Good
1.75 - Good
2.00 - Highly Satisfactory _____________________________
2.25 - Satisfactory Name
2.50 - Batter than Average
2.75 - Average __________________________
3.00 - Passed Position

__________________________
Office/Agency

__________________________
Date
 18

FORM 18 - SAMPLE COVER PAGE FOR THE NARRATIVE REPORT

College Of Business
Accountancy Department

(name/s of intern/s)

Submitted in fulfillment of the requirements for the course

Public Administration 116- Internship in Government Administration

Bukidnon State University

(Date Submitted)