School

of Business & Management Institut Teknologi Bandung

Assignment Cover Sheet for Students

An assignment cover sheet needs to be included with each assignment. Please complete all detail clearly. If you are submitting the assignment on paper, please staple this sheet to the front of each assignment. If you are submitting the assignment online, please ensure this cover sheet is included at the start of your document. (This is preferable to a separate attachment.) The submission method should be done according to the instructors instructions. Name Student ID Course code and title Course time and place Lecturer Assignment number Assignment title/topic/case Assignment type (choose one) ( ) Midterm Exam ( ) Final Exam ( ( ( ) Individual Assignment ) Group Assignment ) Other Due date Program Mobile phone

Further information (e.g. state if extension was granted and attach evidence of approval, revised submission date)

I declare that the work contained in this assignment is my own, except where acknowledgement of source is made. I authorize SBM ITB to test any work submitted by me, using text comparison software, for instances of plagiarism. I understand that this will involve the SBM ITB or its contractor copying my work and storing it on a database to be used in future test work submitted by others. Note: The attachment of this statement on any electronically submitted assignments will deemed to have the same authority as a signed statement.

Signed Filled out by lecturer/tutor Date received from student Recorded

Date

Assessment/grade

Assessed by

Dispatched (if applicable)