Assessment Details Qualification Code/Title Assessment Type Due Date Due Date Location Term / Year AHIC Unit of Competency National Code/Title Learner Details Learner Name Learner ID Learner Declaration: I declare that the work submitted is my own, and has not been copied or plagiarised from any person or source. Signature: ____________________________ Date: _____/______/__________ Assessor Details Assessor’s Name RESULTS (Please Circle) SATISFACTORY NOT SATISFACTORY Feedback to learner: ............................................................................................................................................................................................... ............................................................................................................................................................................................... ............................................................................................................................................................................................... ............................................................................................................................................................................................... Learner Declaration: I declare that I have been assessed in this unit, and I have been advised of my result. I am also aware of my appeal rights. Signature: _______________________________ Date: ______/_______/___________ Assessor Declaration: I declare that I have conducted a fair, valid, reliable and flexible assessment with this learner, and I have provided appropriate feedback. Signature: ________________________________________ Date: ______/_______/___________ Australian Harbour International College, 114-120 Castlereagh Street, Sydney NSW 2000, Australia |RTO NO: 41338 | CRICOS Provider Code: 03449J Filename: Assessment Cover Page Version 7.0/ November 2016 Review Date: July 2017 Page 1 of 1
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