DOLE REGIONAL OFFICE _____
GOVERNMENT INTERNSHIP PROGRAM (GIP) BENEFICIARIES MONITORING FORM
NAME NATURE OF DURATION OF CONTRACT
ADDRESS AGE GENDER EDUCATIONAL DOCUMENTS OFFICE/PLACE WORK/
(Last Name, First Name, MI) ATTAINMENT SUBMITTED OF ASSIGNMENT
ASSIGNMENT
START DATE END DATE
AVENIDO AIVEE, 521 BARANGAY SAN GREGORIOM
CABARUGIAS ALAMINOS LAGUNA 18 FEMALE GR12 SENIOR HIGHSCHOOL
Prepared by: Noted by:
______________________________________________ ____________________________________
Name, Position/Designation and Signature Regional Director
Date: ____________________________
*Please note that this monitoring report must contain actual name of beneficiaries as of the date the report was submitted. All reportorial requirements must be submitted every quarter or five (5) days after the reference quarter to the BLE via email at gip.ble.dole@gmail.com a
website.
DOLE-GIP Form E
REMARKS
(e.g. Contract completed or
preterminated
_____________________
e@gmail.com and posted at the RO
DOLE-GIP Form F
DOLE REGIONAL OFFICE _____
GOVERNMENT INTERNSHIP PROGRAM (GIP) BENEFICIARIES MONITORING FORM
NAME NATURE OF DURATION OF CONTRACT REMARKS Contact No.
EDUCATIONAL DOCUMENTS OFFICE/PLACE
ADDRESS AGE GENDER WORK/
ATTAINMENT SUBMITTED OF ASSIGNMENT
ASSIGNMENT (e.g. Contract
Last Name First Name MI START DATE END DATE completed or
preterminated 9300682489
C. 18 FEMALE GR12 1-Jul 31-Dec
AVENIDO AIVEE 521 SAN GREGORIO
1-Jul 31-Dec
ENROLLMENT FORM TO GROUP PERSONAL AC
OF THE GOVERNMENT SERVICE INSUR
REPUBLIC OF THE PHILIPPINE
DEPARTMENT OF LABOR AND EMPL
Employment Programs of DOLE (SPES/G
DOLE's Program : SPES
Name of Employer : DEPARTMENT OF LABOR & EMPLOYMENT
Address : 3rd & 4th Floor Andenson Bldg. II, Brgy. Parian, Calamba City
Name of Assured :
Address :
Period of Coverage : July 1, 2021 to July 1, 2022
Name of Insured* Address
Extension Date of
Surname First Name Middle Initial/Name Name Birth Age
AVENIDO AIVEE CABARUGIAS 10-28-2002 18
N/A
Prepared by:
Daisy G. Ramos
Senior Labor and Employment Officer
ANNEX A
O GROUP PERSONAL ACCIDENT INSURANCE
NMENT SERVICE INSURANCE SYSTEM
PUBLIC OF THE PHILIPPINES
ENT OF LABOR AND EMPLOYMENT
Programs of DOLE (SPES/GIP/DILEEP)
FOR GIPs ONLY
Brgy. City/Municipality Province District Beneficiary VALID ID
ALAMINO
SAN GREGORIO ALAMINOS LAGUNA
S
Noted by:
Guido R. Recio
Provincial Director
VALID ID# CONTACT# EMAID AD
9300682489 avenidoaivee@gmail.com