Professional Documents
Culture Documents
Please follow these instructions carefully before completing the PDF Cover Sheet provided below.
1 This form is an interactive PDF and must be completed on screen and uploaded to Submit for Assessment.
2 Additional copies of this form can be downloaded from the samples database www.cambridgeinternational.org/samples
A Coversheet must be submitted for every candidate in the sample for Component 03.
Candidates must complete Part A and the teacher responsible for teaching the course must complete Part B.
Part A
The total number of words is (The maximum permitted is 1000 words for the Reflective Paper) 1012
Part B
Teacher declaration: I verify that I have supervised sufficient work to enable me to sign this statement of authentication with confidence and that this is
the candidate’s own work. The work has been fully checked and these checks included looking for:
I also confirm that syllabus regulations relating to the role of the teacher have been observed.