FRM/EDPD/054

C A R I B B E A N E X A M I N A T I O N S C O U N C I L
CARIBBEAN SECONDARY EDUCATION CERTIFICATE®
MODERATION OF SCHOOL-BASED ASSESSMENT
CHEMISTRY
NAME OF CENTRE: _______________________________________________________________ CENTRE CODE: _______________________________________

NAME OF TEACHER: _____________________________________________________________ NUMBER OF CANDIDATES IN CENTRE: : _________________

TERRITORY: ____________________________________________________________________ YEAR OF EXAMINATION: _______________________________

FOR USE IN 2021 ONLY

For CXC use only
Teacher I.D. No.: _________________

PRACTICAL SKILLS
Obs./Rec./ Manip./ Plan./ Analysis & OVERALL
PROFILE TOTAL
Registration ASSESSOR Rep. Meas. Design. Interpr. TOTAL
Candidate’s Name
Number P3 (20) P3 (20) P3 (30) P2 (40) P2 (40) P3 (70) 110

Teacher

1. Moderator

Teacher

2 Moderator

Teacher

3.
Moderator

Teacher

4.
Moderator

Teacher

5.
Moderator

MODERATOR’S INITIALS: _________________ CHIEF/ASSISTANT EXAMINER’S INITIALS: _________________ EXAMINER’S INITIALS: ___________________ DATE: ________________________________

Revised March 2021

To be sent to the Local Registrar for submission to CXC