Republic of the Philippines

Office of the President

COMISSION ON HIGER EDUCATION
LOCAL OFF-CAMPUS ACTIVITIES
REPORT OF COMPLIANCE
Name of HEI : WESTERN MINDANAO STATE UNIVERSITY Region : IX
Address : Normal Road, Baliwasan, Zamboanga City 7000

BASIC INFORMATION:

PROGRAM DESTINATION INCLUSIVE NO. OF LIST OF PERSONNEL

COURSE/EVENT
NAME AND VENUE DATES STUDENTS INCHARGE
MANILA, MR. JAYDEE C. BALLAHO
PHILIPPINES (Adviser, Overall
BACHELOR OF CS 141 (QUEZON, Personnel in-charge)
JUNE 04,
SCIENCE IN (ON-THE-JOB
TAGUIG, MAKATI,
LAGUNA, JUNE 11, 35 ENGR. GADMAR M.
COMPUTER TRAINING/INDUSTRY
TAGAYTAY, 2023 BELAMIDE
SCIENCE IMMERSION)
BATANGAS, SUBIC
AND BAGUIO
(Chaperon, Personnel in-
CITY) charge)

REPORT BEFORE THE ACTIVITY:

ACTIVITIES YES/NO REMARKS
1. Curriculum Requirement It is part of the curriculum for BS
COMPUTER SCIENCE as per CMO-25-
YES s.-2015, 3rd year Summer CS 141 (ON-
THE-JOB TRAINING /INDUSTRY
IMMERSION)
2. Destination Destination Map: MANILA, PHILIPPINES
(QUEZON, TAGUIG, MAKATI,
YES
LAGUNA, TAGAYTAY, BATANGAS,
SUBIC AND BAGUIO CITY)
3. Handbook or Manual YES CCS Manual on Off-Campus Activities
4. Acknowledgement of Risks and waiver of liability of the Notarized Parents’ Consent, Medical
Parents/Guardian and Medical Clearance of the Students certificate issued by Dr. Felicitas
YES
Asuncion C. Elago (University
Physician)
5. Personnel in-charge Mr. Jaydee C. Ballaho and
YES
Engr. Gadmar M. Belamide
6. First Aid kit YES Complied
7. Fees/Funds Financial Assistance will be requested
YES
from the university
8. Insurance YES Various Insurance Company
9. Mobility of Student (Vehicle)
Owned by DJM TRAVEL AND TOURS
Owned by the HEI third part or by subcontracting YES
AGENCY
Franchise/Travel Agency/ Tour Operator
10. LGUs/NGO NO NOT APPLICABLE
11. Activities
Orientation to Students CS 141 (ON-THE-JOB TRAINING
Consultation /INDUSTRY IMMERSION)
Announcements YES
Briefing before the trip
Orientation/Consultation/ Announcement
Learning Journals
discussed with the Parents on MAY 02,
Emergency Preparedness Plan
2023 (IN-PERSON)

Certified True and Correct: Recommending Approval:

JAYDEE C. BALLAHO DR. NURSIA M. BARJOSE

Adviser, Overall Personnel in-charge Vice President for Academic Affairs

ENGR. GADMAR M. BELAMIDE

Chaperon, Personnel in-charge

Reviewed by: Approved by:

DR. RODERICK P. GO DR. MA. CARLA A. OCHOTORENA

 Republic of the Philippines
Office of the President
COMISSION ON HIGER EDUCATION
Dean University President