APPENDIX 1

NGC3 The Health and Safety Practical Application

Candidate and course provider declarations:

For completion by the candidate:

I declare that the work submitting for this practical application assessment ie. the completed
observation sheets and the report to management, is my own work. I recognize 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 a course provider representative (e.g.

internal practical assessor):

I declare that the work marked is identical to that received from the candidate. I recognize
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 providers 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 candidates script. If this declaration is not
submitted the candidates result may be declared void.

Unit NGC3: Health and Safety Practical Application Guidance and Information
APPENDIX 4
NATIONAL GENERAL
CERTIFICATE Candidates
observation
(2009 specification) sheet

NGC3 THE HEALTH AND

SAFETY PRACTICAL APPLICATION
Sheet number o
f

Student Student
name number

Place Date of / /
inspected inspection

Observations Control measures Timescale

Immediate, medium and longer-term (immediate,
Hazards / Good practice
actions 1 week, etc)

Unit NGC3: Health and Safety Practical Application Guidance and Information
APPENDIX 5
NATIONAL GENERAL
CERTIFICATE Candidates report
template
(2009 specification)

NGC3 THE HEALTH AND

SAFETY PRACTICAL APPLICATION

Student
name

Place Date of / /
inspected review

Unit NGC3: Health and Safety Practical Application Guidance and Information
Structure report under the following headings:

Introduction including overview of area inspected and activities taking

place

Executive Summary

Main findings of the inspection

Conclusion

Recommendations include as a table in the following format:

Recommendation Likely resource Priority Review date

implications

Unit NGC3: Health and Safety Practical Application Guidance and Information