GC3 – The Health and Safety Practical Application
Candidate and course provider declarations:
For completion by the candidate:
I declare that the work submitted for this practical application assessment ie. The completed observation sheets
and the report to management, is my own work. I recognise that contravention of this statement constitutes
malpractice and may result in my being subject to the penalties set out in the NEBOSH Malpractice policy.
Name (Print) Khurram Rasheed
Signature
Date 05-05-2018
For completion by a course provider representative (e.g. internal practical assessor):
I declare that the work marked is identical to that received from the candidate. I recognise that contravention of
this statement constitutes malpractice and may result in my being subject to the penalties set out in the NEBOSH
Malpractice policy.
Name (Print) _________________________________
Signature _________________________________
Date _________________________________
For completion by the course provider’s internal practical assessor:
I declare that I have marked this work and am both qualified and approved by NEBOSH to do so. I recognise
that contravention of this statement constitutes malpractice and may result in my being subject to the penalties
set out in the NEBOSH Malpractice policy.
Name (Print) _________________________________
Signature _________________________________
Date _________________________________
NB: This declaration must be completed in full, submitted and retained with the
candidate’s script. If this declaration is not submitted the candidate’s result may be
declared void.
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