BSF

LEMBAGA PEPERIKSAAN MALAYSIA

KEMENTERIAN PELAJARAN MALAYSIA

BATCH SCORE FORM

INFORMATION AND COMMUNICATION TECHNOLOGY

CENTRE CODE: JD069 SCHOOL CODE: JEA3052 YEAR: 2011

Identity Card
No Index Number Name M1 M2 M3 M4 M5 M6 Score
Number
1.
2.
3.
4.
5.
6.
7.
8.
9.
10
.
Assessor’s Declaration Internal Verifier’s Declaration

This is to certify that the ICT coursework scores have been awarded in accordance I confirm that the assessor’s declaration above is true.
with the requirements of the syllabus and that every reasonable step has been taken
to ensure that the work presented is the candidate’s own work.
Assessor’s Signature Internal Verifier’s Signature

---------------------------------- ----------------------------------
Name : MUHAMMADD NURDEEN ABDULLAH Name : PN. HJ SALMAH BT MADON
Date : 31 JULY 2011 Date : 1 AUGUST 2011
School’s Official Stamp:

- i
 BSF
LEMBAGA PEPERIKSAAN MALAYSIA
KEMENTERIAN PELAJARAN MALAYSIA

BATCH SCORE FORM

INFORMATION AND COMMUNICATION TECHNOLOGY

CENTRE CODE: xx SCHOOL CODE: xxxx YEAR: 2011

Identity Card
No Index Number Name M1 M2 M3 M4 M5 M6 Score
Number
11
.
12
.
13
.
14
.
15
.
16
.
17
.
18
.
19
.
20
.
21
.

- ii
 Assessor’s Declaration Internal Verifier’s Declaration

This is to certify that the ICT coursework scores have been awarded in accordance I confirm that the assessor’s declaration above is true.
with the requirements of the syllabus and that every reasonable step has been taken
to ensure that the work presented is the candidate’s own work.
Assessor’s Signature Internal Verifier’s Signature

---------------------------------- ----------------------------------
Name : xxxx Name : xxxx
Date : 31 JULY 2011 Date : 1 AUGUST 2011
School’s Official Stamp:

- iii