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Candidate Authentication form
“This declaration must be completed and signed by the student and countersigned by the tulor or assessor.
Guidance for candidate
You nave bean asked to sgn this Candidate Authentication form and place it atthe front of your
portoio I conf that tha work you have submited for assessment fs your own andthat you have
Fot coped it from someone else or slowed another candidate to copy from you,
Candidate declaration
Teonfem that he oftachod pore eall my own work! and does not neue any wrk completely anyone
‘ter than mye
‘Qualification tit UAL Giective alia Gkendad Diploma Level3|
CngERWSTRTET oon George Mala
Candas oar) [Pas | 30-41 723
“unless otherwise state, candidates can work together but should show sections whish are their ov work
LUAL Awarding Body is collecting images of students" work for is online gallery an for use n materials to
help teach tis qualfeation fa ather students. This wil largely happen va our website but we may also Use
‘Some images In ou printed publications such asthe course specication for his qualication,
Approval for use of own work
Should we ienty your work for use inthis way, we would be very grateful if you woul! alow us to
otograph it
[yea agen a yur war way, in lass a
Pa nae awa Se
JETWAN AAI)
Centre confirmation of authenticity
Onbehatol (nse contre name) Ta. Ue alla. coni nat te akve martened
Candidate to the best of my knowledge, i the sole autict of he completed assignmentportlio
fatlached and the assessments have been completed under the requred conditions.
Tutor of assessor declaration
| confirm tha, inline with the requirements ofthe course andthe quality procedures operated by the
Cente al reasonable stops have been taken to moniter the authenbiy of students’ work for his
‘assessment session.
Rent eines Baer (Sic Sn |
centre =
Po S25 I
UAL Avarng By canddate authentication for V2.t