Assignment Submission Form

The cover sheet below must be attached to your assignment. Your assignment will not be accepted if the cover sheet is not attached. You must submit your assignment to your teacher, in class, on the date your teacher specifies. When you submit your assignment, you must place your signature on both parts of this document (the Assignment Cover Sheet and the Assignment Submission Receipt). You must tear off the assignment submission receipt and keep it. If you are unable to produce the assignment submission receipt when requested, your assignment will be assessed as Not Yet Complete. You must keep a copy of your assignment. If you are unable to produce a copy of your assignment when requested, your assignment will be assessed as Not Yet Complete.

Assignment Cover Sheet

Module Teacher Assessment Description (number and name of assessment) Declaration: 1. This assignment is my own work. 2. I specified in my assignment any assistance I received in its preparation and I referred to any sources from which I used data, ideas, or words, either quoted directly or paraphrased. 3. This assignment was prepared by me specifically for this module, as directed by my teacher. I certify the above to be true. By signing this statement, I agree to the penalties that apply in the event of any breach of academic conduct, including copying, cheating and plagiarism. Student ID Student name Signature Group Number (if applicable) Due Date

For authorised group assignments, all students who have contributed to the assignment sign above. Students whose names do not appear will not get a mark for this assignment.

Assignment Submission Receipt (please tear off)

This receipt must be retained and submitted if requested Module: ________________________________ Date of Submission: ______________________ Assessment Description: _______________________ Student ID: __________________________________

Student Name: ___________________________ Student Signature: ____________________________ Teacher Name: ___________________________ Teacher Signature: ____________________________
Assignment Submission Form v2.0 August 2007