Work Immersion Portfolio Template and Forms

SAN PABLO NATIONAL HIGH SCHOOL -SHS
PORTFOLIO TABLE OF CONTENTS

PORTFOLIO FORMAT
A. Portfolio Labels
1. Title Page
2. Table of Contents
B. Part I. (Pre-immersion)
1. Resume
2. Picture/documentation during pre-immersion orientation
3. Certificate of participation during pre-immersion orientation
4. Parent’s consent
5. Parent’s waiver
c. Part II. (Immersion proper)
1. Vision and mission of the department
2. Picture of the department/area (Work site)
3. Organizational chart of the department
4. Task sheets (10 copies/ prepare 1 task sheet per day) with signature of
immersion supervisor
5. Documentation (pictures with captions and date)
6. Daily immersion reports (10 copies/ prepare 1 copy per day) with
signature of Immersion Supervisor
7. DTR (Daily Time Record signed by the student and immersion
Supervisor)
D. Part III. (Post immersion)
1. Certificate of completion/Certification
3. Updated resume
5. Narrative Report about the immersion experience
4. Reflection Paper
5. Evaluation form graded and signed by the immersion supervisor
6. Portfolio Evaluation Form
[Type here]
Student Name: Grade and Section:

Track/Strand: Schedule:
Department:
Industry Partner:
Immersion Supervisor:
CONTENTS Page no.

A. Portfolio Labels
1. Folder Cover
2. Title Page (Refer to last page of the Template)
3. Table of Contents
4. Portfolio Evaluation Form
1. Resume
2. Picture/documentation during pre-immersion orientation
3. Certificate of participation during pre-immersion
orientation
4. Parent’s consent
5. Parent’s waiver
C. Part II. (Immersion proper)
1. Vision and mission of the department

2. Picture of the department/area (Work site)
3. Organizational chart of the department
4. Task sheets (10 copies/ prepare 1 task sheet per day) with
signature of immersion supervisor (10 points/day)
5. DTR (Daily Time Record signed by the student and
immersion Supervisor)
D. Part III. (Post immersion)

1. Certificate of completion/Certification
2. Evaluation form graded and signed
by the immersion supervisor
3. Updated resume
4. Reflection Paper
5. Narrative Report about the immersion experience
Student's Name and Signature Signature:
Parent's Name and Signature Signature:
Teacher's Name and Signature Signature:
[Type here]
TASK SHEET NO._______

Student Name: Grade and Section:
Industry Partner: Department:
Immersion Supervisor: Signature:
Title of task:
Performance
Objectives:
Supplies : Equipment:
STEPS/PROCEDURES:
Note: Describe the procedures how you perform specific task in behavioral terms.
1.
2.
3.
4.
5.
6.
7.
8
9.
10.
11.
12
13.
14.
15.
16.
Assessment Method
Signature of Student
Signature of Supervisor
Date Performed
[Type here]
DAILY IMMERSION REPORT IM FORM 3

Series 2016
Student Name
Track/Strand
Grade and
Section
Industry Partner
Department
Immersion
Supervisor
Instructions:
This should be accomplished at the end of the day. Completion of this form is
necessary as a proof of a daily routine in the work place.
TIME DESCRIPTION
Learning for the day:
Time In Date
Time Out Supervisor
Working Hours Date Checked
[Type here]
I attest that the report is true and

Signature
correct
NARRATIVE REPORT
Student Name
Track/Strand
Grade and Section
Industry Partner
Department
Immersion
Supervisor
[Type here]
CERINA V. GALOY
Signature of student over printerd name
[Type here]
REFLECTION PAPER
Student Name
Track/Strand
Grade and Section
Industry Partner
Department
Immersion
Supervisor
CERINA V. GALOY
Signature of student over printerd name
[Type here]
Republic of the Philippines

Department of Education
Region 02(Cagayan Valley)
SCHOOLS DIVISION OF ISABELA
PORTFOLIO EVALUATION
SAN PABLO NATIONAL FORM
HIGH SCHOOL
Poblacion, San Pablo Isabela
Grade and
Student Name:
Section:
Industry Partner: Department:
Immersion Supervisor:
Highest
Possible Score
CONTENTS Score (HPS)
A. Portfolio Labels
(20 pts.)
5. Folder Cover 5
6. Title Page (Refer to last page of the
5
Template)
7. Table of Contents 5
8. Portfolio Evaluation Form 5
6. Resume (20 pts.)
7. Picture/documentation during pre-

5
immersion orientation
8. Certificate of participation during pre-
5
immersion orientation
9. Parent’s consent 5
10. Parent’s waiver 5
C. Part II. (Immersion proper) (130 pts.)
6. Vision and mission of the department 10

7. Picture of the department/area (Work site) 5
8. Organizational chart of the department 10
[Type here]
9. Task sheets (10 copies/ prepare 1 task sheet

per day) with signature of immersion 100
supervisor (10 points/day)
10. TR (Daily Time Record signed by the student
5
and immersion Supervisor)
D. Part III. (Post immersion) (50 pts.)
1. Certificate of ompletion/Certification 5
2. Evaluation form graded and signed
5
by the immersion supervisor
3. Updated resume 5
4. Reflection Paper 15
6. Narrative Report about the immersion
20
experience
TOTAL 120 pts.
Student's Name: Signature:
Parent's Name: Signature:
Teacher's Name: Signature:
[Type here]
[Type here]

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SAN PABLO NATIONAL HIGH SCHOOL -SHS

PORTFOLIO TABLE OF CONTENTS

Student Name: Grade and Section:

CONTENTS Page no.

C. Part II. (Immersion proper)

1. Vision and mission of the department

3. Organizational chart of the department

D. Part III. (Post immersion)

Student's Name and Signature Signature:

Parent's Name and Signature Signature:

Teacher's Name and Signature Signature:

TASK SHEET NO._______

DAILY IMMERSION REPORT IM FORM 3

Learning for the day:

Time Out Supervisor

Working Hours Date Checked

I attest that the report is true and

Republic of the Philippines

6. Resume (20 pts.)

7. Picture/documentation during pre-

C. Part II. (Immersion proper) (130 pts.)

6. Vision and mission of the department 10

9. Task sheets (10 copies/ prepare 1 task sheet

Student's Name: Signature:

Parent's Name: Signature:

Teacher's Name: Signature:

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