waiver (new)

Republic of the Philippines POLYTECHNIC UNIVERSITY OF THE PHILIPPINES OFFICE OF THE VICE PRESIDENT FOR ACADEMIC AFFAIRS COLLEGE OF ENGINEERING DEPARTMENT OF ELECTRICAL ENGINEERING WAIVER KNOW ALL MEN BY THESE PRESENTS: I, Maverick John L. Cabrito , Filipino, 19 years of age, single/married. With residence at Rd. 2 I. Marcelo St., Malanday, Valenzuela City and presently enrolled at the Polytechnic University of the Philippines, College of Engineering and Architecture, Sta. Mesa, Manila, hereby voluntarily renounce and waive, with the consent and conformity of my parents/guardian, all claims that I may have against Polytechnic University of the Philippines, and/or its officials, arising from any cause/s that may occur in connection with my On the Job Training at ALCON Philippines Technologies and Solutions Inc . This waiver is valid only on the duration of the said On-the-Job Training. IN WITNESS WHEREOF, I hereby affix my signature this _______ day of _________, ______ at ______________________________. WITH MY CONSENT AND CONFORMITY: ______________________________________ ____________________________ Parent/Guardian’s signature over printed name Signature of student SUBSCRIBED AND SWORN to before me, this _____ day of __________, ______, by _________ _____________________, who exhibited to me his Residence Certificate No. __________________ Issued at _________________________ on _______________________. Notary Public Until May 31, _______ PTR No. ________________ Doc. No. _____ Page No. _____ Book No. _____ Series of _____ PUP NDC Campus Anonas Street, Sta. Mesa, Manila Phone: (Direct Line): 7166273 website: www.pup.edu.ph e-mail: [email protected] “THE COUNTRY’S 1 st POLYTECHNICU” CTC NO. Issued at on ________________ ________________ ________________

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Republic of the PhilippinesPOLYTECHNIC UNIVERSITY OF THE PHILIPPINES OFFICE OF THE VICE PRESIDENT FOR ACADEIC AFFAIRSCOLLE!E OF EN!INEERIN!DEPARTMENT OF ELECTRICAL ENGINEERING

WAIVERKNOW ALL MEN BY THESE PRESENTS:I,Maverick John L.a!ri"o, #i$i%ino,&'(ear) o* a+e,)in+$e,-arrie.. Wi"h re)i.ence a"R.. / I.Marce$o S"., Ma$an.a(, 0a$en12e$a i"(an. %re)en"$( enro$$e. a" "he Po$("echnic 3niver)i"( o* "hePhi$i%%ine), o$$e+e o* En+ineerin+ an. Archi"ec"2re, S"a. Me)a, Mani$a, here!( vo$2n"ari$(reno2nce an. 4aive, 4i"h "he con)en" an. con*or-i"( o* -( %aren"),+2ar.ian, a$$ c$ai-) "ha" I -a(have a+ain)" Po$("echnic 3niver)i"( o* "he Phi$i%%ine), an.,or i") o**icia$), ari)in+ *ro- an( ca2)e,)"ha" -a( occ2r in connec"ion 4i"h -( On "he Jo! Trainin+ a" ALON Phi$i%%ine) Techno$o+ie) an.So$2"ion) Inc.Thi) 4aiver i) va$i. on$( on "he .2ra"ion o* "he )ai. On5"he5Jo! Trainin+.IN WITNESS WHEREO#, I here!( a**i6 -( )i+na"2re "hi) 7777777 .a( o* 777777777, 777777 a"777777777777777777777777777777.WITH MY ONSENT AN8 ON#ORMITY:777777777777777777777777777777777777777777777777777777777777777777Paren",92ar.ian:) )i+na"2re over %rin"e. na-e Si+na"2re o* )"2.en"S3BSRIBE8 AN8 SWORN "o !e*ore -e, "hi) 77777 .a( o* 7777777777, 777777, !( 777777777777777777777777777777, 4ho e6hi!i"e. "o -e hi) Re)i.ence er"i*ica"e No. 777777777777777777I))2e. a" 7777777777777777777777777 on 77777777777777777777777.No"ar( P2!$ic3n"i$ Ma( ;&, 7777777PTR No. 77777777777777778oc. No. 77777Pa+e No. 77777Book No. 77777Serie) o* 77777PUP NDC C"#pus Anon"s St$eet% St"& es"% "nil"Phone' (Di$ect Line)'*+,,-*. /ebsite' ///&pup&e0u&ph e1#"il' ce2pup&e0u&ph3THE COUNTRY4S +st POLYTECHNICU5T NO.I))2e. a"on 777777777777777777777777777777777777777777777777

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