Institute of Lifelong Learning
ASSIGNMENT SUBMISSION FORM
(= ASSIGNMENT TRACKING RECORD)
Please complete this form in BLOCK CAPITALS and attach it to your essay.
Fill in the tear off slip at the bottom if you require a receipt,
Course Title:
Name of Student/Student ID No.:
Year:
Telephone Number:
Name of Tutor:
Name of Module:
Title of Assignment:
Set Essay Length:
Deadline set:
Word Count:
Date of submission:
Date sent to tutor:
Date sent to moderator:
Date mark agreed:
Date Returned to student:
Student Declaration:
I declare that this assignment is my own work, that all sources of reference are acknowledged in
full and that it has not been submitted for any other course.
Signed ………………………………………………………………...
Date ………………………..
RECEIPT FOR ASSIGNMENT
Title of Course:
Name of Student:
Year:
Name of Tutor:
Module:
Title of Essay:
Deadline for essay:
Date of submission:
Received by:
Date:
August 2010