SENIOR HIGH SCHOOL WORK IMMERSION
PARENTAL CONSENT FORM
Instructions: Please fill all the necessary information and return to the Work Immersion Teacher on or
before the deadline.
Name of Student: _____________________________________________________ Age: ____________
Name of the Parent/ Guardian: _______________________ Relationship to the Student: _____________
Complete Address: ________________________________ Mobile Numbers: ______________________
CONSENT (please read carefully)
1. I willingly and voluntarily give consent to my son/daughter to be sent for Work Immersion as part of
the requirement set by the Department of Education in the Senior High School wherein my
son/daughter will be deployed in _______________________________________________________
(name of immersion partner and address)
2. I fully support the Work Immersion of my son/daughter through minimal financial cost and through
my attendance/presence if so desired.
3. I consent my son/daughter travelling by any form of public/private transport by land as long as it is
within the scope of its activities and training.
4. I have considered the benefits that my son/daughter will derive from his or her Work Immersion
provided that due care and precaution will be observed to ensure the comfort and safety of my
son/daughter and that teachers/ school/company may not be held responsible for any untoward
incident that may happen beyond their control.
5. I am fully aware that the Minimum Health Protocol will be properly observe during the duration of
the Work Immersion.
Signed by:
_______________________________________
Signature of Parent/Guardian Over Printed Name
Contact Number: _________________________
Date: __________________________________