Assessment Cover Sheet Please attach this sheet to the front of your Assessment/ Homework before submitting for marking If this form is not signed and filled in appropriately your Assessment/Homework cannot be marked as ‘Competent’ Students Name Unit Code Unit Title Group No./ Funding Source Date Unit Attended Date Submitted Trainers Name Declaration 1. I have read and understood the Plagiarism and Collusion information in the Student Handbook 2. This assessment is solely the product of my own original work except where acknowledged as coming from another person or source. Students Name Students Signature Date Please Note; 1. You must fill in all fields provided 2. Only ONE unit of homework per plastic sleeve 3. Write the unit code and your name on the top right hand corner of loose sheets/ pages of your work (this ensures it is identified, and returned to you) TRAINER USE ONLY ☐ No additional assessment tasks required ☐ Additional assessment tasks required – Resubmission required (see comments on Competency Record Page) Z:\shared documents\QMS V3.0\Assessment Cover Sheet & Comp Record Sheet V1.docx ©CSTDC Page 1 of 2 Office Use Only 1. Signed Original to be copied 2. Original to be filed in Students File 3. Copy to be provided to Student Competency Record Sheet After completion of assessment tasks the competency record should be completed and signed by the learner, assessor, and if applicable the supervisor. If competency is not achieved at the first attempt strategies to address gaps in the performance need to be identified and time for reassessment arranged. Student Name Unit code and title Assessment tools used and satisfactory outcomes achieved (Tick) ☐ Knowledge Test (oral/written questions) ☐ Demonstration ☐ Supervisor/ Third Party/ Report ☐ ☐ ☐ Project/s Case Study/s – Scenarios Other Other assessment methods used by the RTO and satisfactory outcomes achieved (please detail) The learner has been assessed as competent in the elements and performance criteria, critical aspects for assessment, required skills and knowledge for this unit and the evidence presented is: ☐ Authentic ☐ Valid ☐ Reliable ☐ Current ☐ Sufficient Assessment ☐ ☐ Academic Pass Competency Achieved Comments: Assessor Name Assessor Signature If the learner is not yet competent in this unit; date for reassessment Date / / Strategies to address gaps in performance feedback Learners Comments ☐ I have received written feedback Students Name Students Signature Date Assessor Name Assessor Signature Date Z:\shared documents\QMS V3.0\Assessment Cover Sheet & Comp Record Sheet V1.docx ©CSTDC Page 2 of 2