Learners name assessors nameunit of competence code

Learner’s name
Assessor’s name
Unit of Competence
(Code and Title)
Date(s) of assessment
Have all observations been performed fully and as required to assess the
competency of the learner?
Yes No
(Please circle)
Has sufficient knowledge been displayed by the learner during all observations? Yes No
(Please circle)
Comments
Provide your comments here:
The learner’s
performance was:
Not yet satisfactory Satisfactory
If not yet satisfactory, date for reassessment:
Learner’s signature
Assessor’s signature
HA_SITXCCS008_Learner Workbook V2.0_7Dec2017

HA_SITXCCS008_Learner Workbook V2.0_7Dec2017