Student Assessment Appeal Form by 9nbFubn

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									                                                                   Student Assessment
                                                                          Appeal Form
Western NSW Region RTO 90333


Student Assessment Appeal Form
This form allows you to make a case for a review of a decision made by a staff member in
regards to a determination of competence or in regards to an RPL/Credit Transfer application


 SECTION 1 – Student and course details (to be completed by the student)
 Student Name                                                  Date of birth
 School                                                         Year/Grade
 BOS Course
 Qualification
 This appeal is             A determination of “Not               An RPL/Credit transfer
 about                       Competent” for one or more             decision
                             units of competency

 SECTION 2 – Internal review process (to be completed by the teacher)
 Teacher                    I have reviewed my original       Date
 declaration                 decision and believe the          student
                             original decision should stand    notified
 Teacher name                                                  Signature
Note an internal review must be completed

 SECTION 3 – Competencies to be reviewed
                                                                        External Review process
 Units of competency that are the subject of the appeal
                                                                     (to be completed by the relevant
 (to be completed by the student)
                                                                          review panel member)
                                                                     RVEC       Review panel assessor

                                                                   Is there a      Is the
                                                                    case for     result to    Initials
 Unit
        Unit code    Unit title                                     review?          be          of
 No.
                                                                                changed?     reviewer
                                                                     (Y/N)         (Y/N)

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Student Assessment Appeal Form                                Western NSW Region RTO 90333
Feb 2012                                                                         Page 1 of 3
                                                                             Student Assessment
                                                                                    Appeal Form
Western NSW Region RTO 90333




 SECTION 4 – Please detail the grounds of your appeal (to be completed by the student)
        This appeal is based on failure to follow published assessment procedure. Outline how the RTO’s
         assessment procedure was not followed in relation to the units of competency indicated above (add
         additional pages if required)




        This appeal is based upon the belief that the evidence provided to the assessor justifies a
         determination of competence. Please complete Section 4 and attach copies of all evidence and
         feedback provided by the assessor. Add extra pages if necessary




 SECTION 4 – Evidence provided for review (to be completed by the student)
 It is the student’s responsibility to provide evidence to the review panel for the purposes of processing their
 appeal. Please list the evidence provided with this application and include a brief explanation. Match each item
 with the relevant unit number(s) from Section 3
 Item       Brief description of the item of evidence provided                              Unit Number




Student Assessment Appeal Form                                         Western NSW Region RTO 90333
Feb 2012                                                                                  Page 2 of 3
                                                                               Student Assessment
                                                                                      Appeal Form
Western NSW Region RTO 90333




 SECTION 4 – Student/school or college/RTO sign-off
 The outcome of the appeal as detailed above has been acknowledged and the student and their parent/carers
 have been made aware of their right to lodge a complaint if they are not satisfied with the final decision.
 RTO representative name:

 RTO representative’s signature:                                               Date:

 Student’s name:

 Student’s signature:                                                          Date:
 Name of principal:

 Signature of principal:                                                       Date:



 SCHOOL OR COLLEGE/RTO USE ONLY (to be completed by the VET Coordinator/ classroom
 teacher)

 Action                                                                            Initial    Date

 The student’s parent/carers have been notified of the decision

 Updated outcomes as indicated in Section 3 have been entered on eBOS
 This form, along with the evidence provided has been filed at the school or
 college in the student’s file

 This appeal has been scanned and uploaded onto RTO Admin




Student Assessment Appeal Form                                        Western NSW Region RTO 90333
Feb 2012                                                                                 Page 3 of 3

								
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