Student name
Student ID
Student’s signature
Unit name:
Unit number:
Tutorial group:
Tutorial date:
Tutorial time:
Lecturer or tutor’s name:
time/date stamp
(For office use only)
Due date:
By signing this form in the space provided above, I declare that:
I hold a copy of this assignment, in the case of the original being lost or damaged.
No part of this assignment or product has been copied from any other student’s work or from any other source
except where due acknowledgement is made in the assignment.
No part of this assignment or product has been submitted by me in another (previous or current) assessment, except
where appropriately referenced, and with prior permission from the lecturer/ tutor/ learning and teaching
coordinator concerned.
No part of this assignment/product has been written/produced for me by any other person except where
collaboration has been authorised by the lecturer/tutor learning and teaching coordinator concerned.
I am aware that this work will be reproduced and submitted to a plagiarism detection software program for the
purpose of detecting possible plagiarism (which program may retain a copy on its database for further plagiarism
An examiner or lecturer/tutor has the right not to mark this assignment if the above declaration has not been signed.
In providing my personal information to Western Sydney University The College I understand that other than as authorised by
law, The College will only use this information for the purposes for which it is being collected with The College’s functions and
activities associated with my enrolment. In some instances, The College may need to disclose information to any government
department which administers or has authority regarding education or immigration policy and law and any other government
agencies (state, territory or federal), an affiliated entity of The College or to third parties for the purposes of recovering unpaid
Western Sydney University The College fees or other debts owed to The College, and I consent to such disclosure. I also
understand that all information will be collected, stored, accessed and disseminated or destroyed in accordance with privacy
records management and other relevant laws and The College policies.
Western Sydney University ABN 53 014 069 881 is a registered provider under the Commonwealth Register of Institutions and
Courses for Overseas Students (CRICOS). Provider Number 00917K.
Western Sydney University Enterprises Pty Limited ABN 44 003 474 468 trading as Western Sydney University The College
(CRICOS Provider Number 02851G) is a wholly owned entity of Western Sydney University. Academic Pathway Programs are
delivered by Western Sydney University The College under arrangement with Western Sydney University.
Western Sydney University The College Group Assignment Cover Sheet 08022018
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