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Student Declaration of Authenticity Form

This declaration must be completed by each student to ensure authenticity and quality procedures operated
by the centre have been followed.

Level 3 Performing and Production Arts


Qualification title:
544824
Group ID:
Assessment / Project title: Glass Town

Unit(s) assessed: Unit 12 FMP

Guidance for Centres


In order to confirm to UAL that the evidence produced by a student is valid and appropriate, centres must
ensure that they keep detailed records evidencing their level of support and control over the formative and
summative assessment.

Student Declaration:

I confirm that the attached assessment is all my own work and does not include any work completed by
anyone other than myself and sources have been appropriately referenced.

Henry Simmons
Student name:

Signature:

Date: 1/06/2023

UAL Awarding Body Student Declaration of Authenticity Form 2021/2022

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