HABC MEA Examination

Learner List and Declaration

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 HABC EXAMINATION LEARNER LIST AND DECLARATION

1. Instructions

1.1 It is the responsibility of the examination Invigilator/Assessor to ensure that all learner scripts
and additional papers including the learner list below are sealed in the security bag provided
and returned to HABC.

1.2 The Invigilator/Assessor is also responsible for signing the declaration at the bottom of this
page.

2. Centre Details

2.1 Centre name: ………………………………………………………..…………………………………………….…………………….

2.2 Centre number: …………………………………………………..……………………………………….……………………………

2.3 Address of examination venue (if different to Centre address): …………………….………..…….……..

………………………………………………………………………………………………………………………………………..………………

2.4 Contact telephone number: …………………………………………………………………………….…………..……………

2.5 Name/number of Nominated Tutor: ……………………………………………...................………..………………

2.6 Examination title: ………………………………………………………………………………………………………………………..

2.7 Examination date: ……………………………..……………………………………………………………….……………………….

2.8 Number of learners: ……………….…………. 2.9 Course ID: ………………………………………….

3. Invigilator Declaration

3.1 I confirm I have invigilated the examination in accordance with HABC regulations.

3.2 I confirm that I read a copy of the Invigilation Instructions prior to invigilating this examination
and have adhered to the same.

3.3 I confirm that the start and finish times of the examination have been entered on to each
Examination Answer Sheet and the learner has signed in the bottom corner.

3.4 I confirm that all examination question papers have been returned to HABC.

3.5 I confirm the security of examination/assessment materials has not been compromised during
transit or at the assessment venue.

3.6 I confirm that I have checked photographic identification for all learners listed on the
Examination Learner List.

Signature: ………………………………………. Print name: ………………………………………… Date: …………….……

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 Date: ……………………...

Course ID ……………………..

Examination Learner List

Learner For
Learner Telephone Gender (Select
First name Middle name Family name Learner Signature identification type Retake
Number (Optional) √ as appropriate)
(Please read the Note) √
Male / Female

Male / Female

Male / Female

Male / Female

Male / Female

Male / Female

Male / Female

Male / Female

Male / Female

Male / Female

Male / Female

Male / Female

Male / Female

Male / Female

Male / Female

Male / Female

Male / Female

Male / Female

Male / Female

Male / Female
Note: Please write the type of ID that you are showing to the invigilator: Passport; Emirates ID (EID); Computerised National ID Card (CNIC); Driving License; Labour
Card; Resident Permit, Resident Identity Card; etcetera. It is not necessary to write the ID number just the type.