CHEM 237L

Report Title Page

(Please print and attach completed page to each report submission.)

Name:

Student ID Number:

Partner's Name:

Section Number:

Locker Number:

Experiment Title:

Date Experiment Performed:

Date Report Due:

Date Report Submitted:

T.A.'s Initials:

Lab Submission Declaration:

I, (the undersigned), declare that this submission is my own work and has not been copied from any
other source without attribution, that this submission is not the result of collaborative effort with
an other individual(s) and that this report is being submitted for the first-time for academic evaluation.
I acknowledge that severe penalties exist for any copying of material from other sources without
attribution, for excessive collaboration and for repeat submissions, including a mark of zero (0) for this course.

Signature:

Lab reports that do not include a signed declaration will not be graded.