Assessor Resource

AVIM5004
Facilitate training in a synthetic environment

Assessment tool

Version 1.0
Issue Date: March 2024


This unit involves the skills and knowledge required to facilitate training in a synthetic environment, in compliance with relevant regulatory requirements of the Civil Aviation Safety Authority (CASA) and national operating standards.

Use of the unit for simulation training activities outside of an aviation context is in accordance with relevant regulatory, organisational or enterprise procedures.

It includes planning a synthetic learning activity; preparing a trainee for these activities; and guiding, facilitating and monitoring learning. It also includes conducting post-training activities and reviewing facilitation processes.

This unit addresses vocational training technical skill requirements (physical, mental and task-management abilities) related to synthetic training and assessment duties of vocational instructors and assessors, and contributes to safe and effective performance in simple and/or complex operational and training environments.

Operations are conducted as part of recreational, commercial and military vocational training activities across a variety of operational contexts within Australian industry.

Work is performed independently or under limited supervision as a single operator or within a team environment.

Licensing, legislative, regulatory or certification requirements are applicable to this unit.

Use for Defence Aviation is to be in accordance with relevant Defence Orders, Instructions, Publications and Regulations.

You may want to include more information here about the target group and the purpose of the assessments (eg formative, summative, recognition)



Evidence Required

List the assessment methods to be used and the context and resources required for assessment. Copy and paste the relevant sections from the evidence guide below and then re-write these in plain English.

ELEMENTS

PERFORMANCE CRITERIA

Elements describe the essential outcomes.

Performance criteria describe the performance needed to demonstrate achievement of the element.

1

Plan a synthetic learning activity

1.1

Learning strategy and/or learning program is accessed, read and interpreted to determine learning outcomes or objectives to be met and relevant delivery requirements

1.2

Potential risks including those associated with human factors aspects of synthetic training devices are identified

1.3

Limitations of synthetic training device are identified

1.4

Delivery plan is developed to plan, manage and sequence synthetic training activities and events to ensure logical progression of learning content, trainee safety and continuity of trainee progress

1.5

Technical and human factors requirements for synthetic environment including safety and emergency procedures, are confirmed

2

Prepare trainee for synthetic training activities

2.1

Availability of suitable resources is confirmed

2.2

Mental and physical preparedness of trainee to undertake training in synthetic environment is confirmed

2.3

Introduction to synthetic environment is provided including training objectives and relevant workplace procedures

2.4

Instructional relationships are established between trainer/facilitator and trainees using appropriate communication tools and skills

2.5

Trainee is briefed on how synthetic training activity will be conducted to meet training objectives

2.6

Risk management issues applicable to synthetic training activity are discussed with trainee and trainee responsibility for managing relevant risks is confirmed

2.7

Trainee ability to comprehend and/or recall training objectives, knowledge, handling techniques and planned synthetic training activity/scenario is confirmed

3

Guide and facilitate learning in a synthetic environment

3.1

Liaison with relevant personnel is conducted to determine simulation activity requirements

3.2

Learning is facilitated in accordance with delivery plan using relevant synthetic devices and facilitation skills

3.3

Good practice in facilitating learning in a synthetic environment is applied to ensure an effective and safe transfer of learning to the real world

3.4

Technical issues are addressed as required using relevant technical support mechanisms and/or personnel

3.5

Opportunities for authentic learning, practice and formative assessment are built into the learning experience

3.6

Pre-loaded automatic demonstrations are employed as required

3.7

Abnormal/unusual conditions are monitored and addressed

3.8

Variations to activity conditions are implemented as required

3.9

Handover/takeover procedures for control of synthetic device are implemented in accordance with workplace procedures

4

Monitor learning in a synthetic environment

4.1

Trainee progress is monitored and documented in accordance with workplace procedures

4.2

Trainee cognitive load is assessed, monitored and managed

4.3

Support and guidance are provided within synthetic environment as appropriate

4.4

Trainee is encouraged to develop self-assessment skills

4.5

Trainee interaction with others and participation in synthetic training activities is continuously monitored, and interventions are made as required

4.6

Opportunities are provided for trainees to reflect on their learning progress

5

Conduct post-training activities

5.1

Significant details of trainee performance are clearly and accurately debriefed

5.2

Playback devices are employed during debriefing to illustrate key learning points as required

5.3

Trainee is briefed on details of next training event as required

5.4

Trainee records are maintained in accordance with workplace procedures

5.5

Relevant stakeholders are kept informed about trainee progress

5.6

Synthetic device faults are recorded and/or rectified in accordance with workplace procedures

5.7

Support and guidance are provided post synthetic environment activities as required

6

Review synthetic environment facilitation processes

6.1

Synthetic training session outcomes are evaluated against desired session outcomes

6.2

Review is undertaken post-completion of learning program, course or qualification

6.3

Time is taken to reflect on own performance as a trainer or facilitator, and ways to improve performance are explored

6.4

Recommendations for improvements in facilitating training and appropriateness of synthetic systems, tools and resources are identified and documented, and discussed with relevant personnel for future action

Evidence required to demonstrate competence in this unit must be relevant to and satisfy all of the requirements of the elements, performance criteria and range of conditions on at least one occasion and include:

adapting to differences in equipment and operating environment in accordance with standard operating procedures

applying flexibility in facilitation when using synthetic devices, for example:

applying intervention techniques

assessing learning and performance

effectively using a variety of activities or providing directions for different trainee needs

conducting briefings and debriefings

confirming technical and human factors requirements for a synthetic environment including safety and emergency procedures

coordinating activities involving a range of complex tasks

coordinating information communications technology related activities

debriefing significant details of trainee performance

developing a delivery plan that ensures logical progression of learning content, trainee safety and continuity of trainee progress

evaluating instructional effectiveness

identifying potential risks including those associated with human factors aspects of synthetic training devices

implementing handover/takeover procedures for control of synthetic device in accordance with workplace procedures

implementing work health and safety (WHS)/occupational health and safety (OHS) procedures and relevant regulations

interpreting trainee needs and directing them to new learning opportunities

maintaining trainee records in accordance with workplace procedures

managing an environment that fosters learning and performance

monitoring and addressing abnormal/unusual conditions

monitoring and documenting trainee progress in accordance with workplace procedures

reading, comprehending and interpreting written technical English

reading, interpreting and following relevant regulations, instructions, procedures, information and signs

reporting and/or rectifying problems, faults or malfunctions promptly, in accordance with workplace procedures

selecting and employing appropriate simulation equipment

selecting and using required personal protective clothing and equipment conforming to industry and WHS/OHS standards

working systematically with required attention to detail without injury to self or others, or damage to goods or equipment.

Evidence required to demonstrate competence in this unit must be relevant to and satisfy all of the requirements of the elements, performance criteria and range of conditions and include knowledge of:

abnormal conditions, including hardware, software and equipment malfunction/failure and poor/unusual trainee performance

advantages and limitations of synthetic training environments in facilitating learning

application of simulation and synthetic activities including live, virtual and constructive (LVC) simulations

common trainee errors and suggested suitable remedial instruction

debriefing and feedback techniques:

individual versus group debrief

basic techniques:

review simulation event

recall what happened

clarify facts

correct misconceptions

reinforce specific learning outcomes

intermediate techniques:

guided reflection of event

coaching methodology

transfer learning responsibility to participants

decisionmaking analysis

cost versus benefit/trade-offs

skill and knowledge technique enhancement

advanced techniques:

less guidance

using media/checklists/video

oral and written evaluation

part of group talks/part listens

varied perspective (observers)

developing and evaluating new concepts

developing self-evaluative learning in participants

documentation production and safe storage

effective use of a course of training, curricula/syllabus and lesson plans

effects of simulation sickness:

nausea subscale:

increased salivation

sweating

nausea

stomach awareness

burping

oculomotor subscale:

fatigue

headache

eyestrain

difficulty focusing

disorientation subscale:

vertigo

dizzy (eyes open)

dizzy (eyes closed)

blurred vision

established procedures applicable to simulation operations

functions of single-user, multi-user and distributed user operating systems

fundamentals of instructing, questioning, engaging and motivating trainees

handover/takeover procedures for controlling synthetic device/s

how to distinguish between a technical problem and a content problem, and how to respond accordingly

human factors implication and risks in a synthetic training environment

information communications technology in a simulation and synthetic environment

intervention strategies, principles and implications for a synthetic environment

relevant learning management systems

relevant WHS/OHS and environmental procedures and regulations applicable to simulation operations and personnel safety

relevant sections of national and state/territory regulatory requirements and codes of practice

sequencing and developing synthetic training activities and their relationship with real world training activities

structure and content of relevant training resources

techniques for introducing tasks in manageable segments to avoid overloading a trainee

training and assessment competency standards

when to intervene and when to let trainees direct themselves

when interventions must be made, to:

address safety

engage trainee

highlight a key learning point

initiate remedial actions

maintain momentum.

As a minimum, assessors must satisfy applicable regulatory requirements, which include requirements in the Standards for Registered Training Organisations current at the time of assessment.

As a minimum, assessment must satisfy applicable regulatory requirements, which include requirements in the Standards for Registered Training Organisations current at the time of assessment.

Assessment processes and techniques must be appropriate to the language, literacy and numeracy requirements of the work being performed and the needs of the candidate.

Assessment must occur in workplace operational situations. Where this is not appropriate, assessment must occur in simulated workplace operational situations that reflect workplace conditions.

Resources for assessment must include access to:

a range of relevant exercises, case studies and/or simulations

acceptable means of simulation assessment

applicable documentation including workplace procedures, regulations, codes of practice and operation manuals

relevant materials, tools, equipment and personal protective equipment currently used in industry.


Submission Requirements

List each assessment task's title, type (eg project, observation/demonstration, essay, assingnment, checklist) and due date here

Assessment task 1: [title]      Due date:

(add new lines for each of the assessment tasks)


Assessment Tasks

Copy and paste from the following data to produce each assessment task. Write these in plain English and spell out how, when and where the task is to be carried out, under what conditions, and what resources are needed. Include guidelines about how well the candidate has to perform a task for it to be judged satisfactory.

ELEMENTS

PERFORMANCE CRITERIA

Elements describe the essential outcomes.

Performance criteria describe the performance needed to demonstrate achievement of the element.

1

Plan a synthetic learning activity

1.1

Learning strategy and/or learning program is accessed, read and interpreted to determine learning outcomes or objectives to be met and relevant delivery requirements

1.2

Potential risks including those associated with human factors aspects of synthetic training devices are identified

1.3

Limitations of synthetic training device are identified

1.4

Delivery plan is developed to plan, manage and sequence synthetic training activities and events to ensure logical progression of learning content, trainee safety and continuity of trainee progress

1.5

Technical and human factors requirements for synthetic environment including safety and emergency procedures, are confirmed

2

Prepare trainee for synthetic training activities

2.1

Availability of suitable resources is confirmed

2.2

Mental and physical preparedness of trainee to undertake training in synthetic environment is confirmed

2.3

Introduction to synthetic environment is provided including training objectives and relevant workplace procedures

2.4

Instructional relationships are established between trainer/facilitator and trainees using appropriate communication tools and skills

2.5

Trainee is briefed on how synthetic training activity will be conducted to meet training objectives

2.6

Risk management issues applicable to synthetic training activity are discussed with trainee and trainee responsibility for managing relevant risks is confirmed

2.7

Trainee ability to comprehend and/or recall training objectives, knowledge, handling techniques and planned synthetic training activity/scenario is confirmed

3

Guide and facilitate learning in a synthetic environment

3.1

Liaison with relevant personnel is conducted to determine simulation activity requirements

3.2

Learning is facilitated in accordance with delivery plan using relevant synthetic devices and facilitation skills

3.3

Good practice in facilitating learning in a synthetic environment is applied to ensure an effective and safe transfer of learning to the real world

3.4

Technical issues are addressed as required using relevant technical support mechanisms and/or personnel

3.5

Opportunities for authentic learning, practice and formative assessment are built into the learning experience

3.6

Pre-loaded automatic demonstrations are employed as required

3.7

Abnormal/unusual conditions are monitored and addressed

3.8

Variations to activity conditions are implemented as required

3.9

Handover/takeover procedures for control of synthetic device are implemented in accordance with workplace procedures

4

Monitor learning in a synthetic environment

4.1

Trainee progress is monitored and documented in accordance with workplace procedures

4.2

Trainee cognitive load is assessed, monitored and managed

4.3

Support and guidance are provided within synthetic environment as appropriate

4.4

Trainee is encouraged to develop self-assessment skills

4.5

Trainee interaction with others and participation in synthetic training activities is continuously monitored, and interventions are made as required

4.6

Opportunities are provided for trainees to reflect on their learning progress

5

Conduct post-training activities

5.1

Significant details of trainee performance are clearly and accurately debriefed

5.2

Playback devices are employed during debriefing to illustrate key learning points as required

5.3

Trainee is briefed on details of next training event as required

5.4

Trainee records are maintained in accordance with workplace procedures

5.5

Relevant stakeholders are kept informed about trainee progress

5.6

Synthetic device faults are recorded and/or rectified in accordance with workplace procedures

5.7

Support and guidance are provided post synthetic environment activities as required

6

Review synthetic environment facilitation processes

6.1

Synthetic training session outcomes are evaluated against desired session outcomes

6.2

Review is undertaken post-completion of learning program, course or qualification

6.3

Time is taken to reflect on own performance as a trainer or facilitator, and ways to improve performance are explored

6.4

Recommendations for improvements in facilitating training and appropriateness of synthetic systems, tools and resources are identified and documented, and discussed with relevant personnel for future action

Range is restricted to essential operating conditions and any other variables essential to the work environment.

Potential risks must include:

effects on what is learned and relationship with the real world

negative learning

Limitations of synthetic training device must include:

fidelity

instrumentation

movement

resolution

Synthetic training devices must include one or more of the following:

associated simulator computer hardware and software

desktop simulator

flight training device

full motion simulator

operating system

part-task trainer

simulator

single, multiple or team operator simulator

synthetic training device

virtual reality training system

Delivery plan must include:

determination of learning management tools such as feedback systems and support mechanisms

individual/group learning objectives or outcomes for learning program or segment of learning program to be addressed

learning/activities/events to be addressed in e-learning sessions

number of trainees and their specific support requirements

resources and/or tools to be used

timing, sequence and number of pre-planned sessions

types of pre-planned sessions – synchronous (in real time using conferencing, chat, forum) or asynchronous (not in real time using email, offline forum, bulletin boards)

topics to be addressed in learning sessions

Safety and emergency procedures must include:

established procedures

industry safe practice

Risk management issues must include one or more of the following:

emergency communication

equipment malfunction/failure

fidelity and resolution constraints/limitations smoke or overheat warnings

loading stops

motion stops

negative learning

simulator access/egress

simulation/motion sickness

TEM

Good practice in facilitating learning in a synthetic environment must include:

assisting trainees in locating, using and evaluating online information

facilitating group work

guiding learning activities through setting up questions, issues, scenarios to be addressed

knowing when to intervene/when to let trainees direct themselves

maintaining momentum and motivation of trainees through ongoing individual contact and feedback

moderating disruptive, abusive or dominant trainees

observing trainee interaction and intervening as required to maintain focus/momentum/engagement

Abnormal/unusual conditions must include one or more of the following:

emergency communication

equipment malfunction/failure

hardware malfunction/failure

loading stops

motion stops

participant simulation sickness

personnel equipment malfunction/failure

poor/unusual participant performance

smoke or overheat warnings

software malfunction/failure

Variations to activity conditions must include one or more of the following:

changes made in response to a strategic requirement

changes made in response to a training need

Cognitive load assessment must include one or more of the following:

anxiety

apathy

fatigue

impatience

inadequate demonstration

inadequate fault analysis

inadequate opportunity to practice

information overload

lack of preparation

outside pressures

physical discomfort

task complexity

unreasonable expectations

Debrief must include one or more of the following:

providing feedback to manufacturer, contracted suppliers and contracted maintainers

providing feedback to relevant organisational authorities

providing feedback to relevant personnel on conclusion of simulator activity

Review must include one or more of the following:

effectiveness of learning protocols, their application and proposed changes

feedback from trainees, colleagues, learning designers via survey or discussion

identification of issues in managing/monitoring e-learners and the need for changes to contact/monitoring processes

identification of issues in using a delivery plan and the need for changes/modifications to the plan

technology effectiveness

Reflecting on own performance must include:

asking critical questions about performance, problems, methods used and success of trainees

seeking, listening to and acting on feedback from trainees and others

Evidence required to demonstrate competence in this unit must be relevant to and satisfy all of the requirements of the elements, performance criteria and range of conditions on at least one occasion and include:

adapting to differences in equipment and operating environment in accordance with standard operating procedures

applying flexibility in facilitation when using synthetic devices, for example:

applying intervention techniques

assessing learning and performance

effectively using a variety of activities or providing directions for different trainee needs

conducting briefings and debriefings

confirming technical and human factors requirements for a synthetic environment including safety and emergency procedures

coordinating activities involving a range of complex tasks

coordinating information communications technology related activities

debriefing significant details of trainee performance

developing a delivery plan that ensures logical progression of learning content, trainee safety and continuity of trainee progress

evaluating instructional effectiveness

identifying potential risks including those associated with human factors aspects of synthetic training devices

implementing handover/takeover procedures for control of synthetic device in accordance with workplace procedures

implementing work health and safety (WHS)/occupational health and safety (OHS) procedures and relevant regulations

interpreting trainee needs and directing them to new learning opportunities

maintaining trainee records in accordance with workplace procedures

managing an environment that fosters learning and performance

monitoring and addressing abnormal/unusual conditions

monitoring and documenting trainee progress in accordance with workplace procedures

reading, comprehending and interpreting written technical English

reading, interpreting and following relevant regulations, instructions, procedures, information and signs

reporting and/or rectifying problems, faults or malfunctions promptly, in accordance with workplace procedures

selecting and employing appropriate simulation equipment

selecting and using required personal protective clothing and equipment conforming to industry and WHS/OHS standards

working systematically with required attention to detail without injury to self or others, or damage to goods or equipment.

Evidence required to demonstrate competence in this unit must be relevant to and satisfy all of the requirements of the elements, performance criteria and range of conditions and include knowledge of:

abnormal conditions, including hardware, software and equipment malfunction/failure and poor/unusual trainee performance

advantages and limitations of synthetic training environments in facilitating learning

application of simulation and synthetic activities including live, virtual and constructive (LVC) simulations

common trainee errors and suggested suitable remedial instruction

debriefing and feedback techniques:

individual versus group debrief

basic techniques:

review simulation event

recall what happened

clarify facts

correct misconceptions

reinforce specific learning outcomes

intermediate techniques:

guided reflection of event

coaching methodology

transfer learning responsibility to participants

decisionmaking analysis

cost versus benefit/trade-offs

skill and knowledge technique enhancement

advanced techniques:

less guidance

using media/checklists/video

oral and written evaluation

part of group talks/part listens

varied perspective (observers)

developing and evaluating new concepts

developing self-evaluative learning in participants

documentation production and safe storage

effective use of a course of training, curricula/syllabus and lesson plans

effects of simulation sickness:

nausea subscale:

increased salivation

sweating

nausea

stomach awareness

burping

oculomotor subscale:

fatigue

headache

eyestrain

difficulty focusing

disorientation subscale:

vertigo

dizzy (eyes open)

dizzy (eyes closed)

blurred vision

established procedures applicable to simulation operations

functions of single-user, multi-user and distributed user operating systems

fundamentals of instructing, questioning, engaging and motivating trainees

handover/takeover procedures for controlling synthetic device/s

how to distinguish between a technical problem and a content problem, and how to respond accordingly

human factors implication and risks in a synthetic training environment

information communications technology in a simulation and synthetic environment

intervention strategies, principles and implications for a synthetic environment

relevant learning management systems

relevant WHS/OHS and environmental procedures and regulations applicable to simulation operations and personnel safety

relevant sections of national and state/territory regulatory requirements and codes of practice

sequencing and developing synthetic training activities and their relationship with real world training activities

structure and content of relevant training resources

techniques for introducing tasks in manageable segments to avoid overloading a trainee

training and assessment competency standards

when to intervene and when to let trainees direct themselves

when interventions must be made, to:

address safety

engage trainee

highlight a key learning point

initiate remedial actions

maintain momentum.

As a minimum, assessors must satisfy applicable regulatory requirements, which include requirements in the Standards for Registered Training Organisations current at the time of assessment.

As a minimum, assessment must satisfy applicable regulatory requirements, which include requirements in the Standards for Registered Training Organisations current at the time of assessment.

Assessment processes and techniques must be appropriate to the language, literacy and numeracy requirements of the work being performed and the needs of the candidate.

Assessment must occur in workplace operational situations. Where this is not appropriate, assessment must occur in simulated workplace operational situations that reflect workplace conditions.

Resources for assessment must include access to:

a range of relevant exercises, case studies and/or simulations

acceptable means of simulation assessment

applicable documentation including workplace procedures, regulations, codes of practice and operation manuals

relevant materials, tools, equipment and personal protective equipment currently used in industry.

Copy and paste from the following performance criteria to create an observation checklist for each task. When you have finished writing your assessment tool every one of these must have been addressed, preferably several times in a variety of contexts. To ensure this occurs download the assessment matrix for the unit; enter each assessment task as a column header and place check marks against each performance criteria that task addresses.

Observation Checklist

Tasks to be observed according to workplace/college/TAFE policy and procedures, relevant legislation and Codes of Practice Yes No Comments/feedback
Learning strategy and/or learning program is accessed, read and interpreted to determine learning outcomes or objectives to be met and relevant delivery requirements 
Potential risks including those associated with human factors aspects of synthetic training devices are identified 
Limitations of synthetic training device are identified 
Delivery plan is developed to plan, manage and sequence synthetic training activities and events to ensure logical progression of learning content, trainee safety and continuity of trainee progress 
Technical and human factors requirements for synthetic environment including safety and emergency procedures, are confirmed 
Availability of suitable resources is confirmed 
Mental and physical preparedness of trainee to undertake training in synthetic environment is confirmed 
Introduction to synthetic environment is provided including training objectives and relevant workplace procedures 
Instructional relationships are established between trainer/facilitator and trainees using appropriate communication tools and skills 
Trainee is briefed on how synthetic training activity will be conducted to meet training objectives 
Risk management issues applicable to synthetic training activity are discussed with trainee and trainee responsibility for managing relevant risks is confirmed 
Trainee ability to comprehend and/or recall training objectives, knowledge, handling techniques and planned synthetic training activity/scenario is confirmed 
Liaison with relevant personnel is conducted to determine simulation activity requirements 
Learning is facilitated in accordance with delivery plan using relevant synthetic devices and facilitation skills 
Good practice in facilitating learning in a synthetic environment is applied to ensure an effective and safe transfer of learning to the real world 
Technical issues are addressed as required using relevant technical support mechanisms and/or personnel 
Opportunities for authentic learning, practice and formative assessment are built into the learning experience 
Pre-loaded automatic demonstrations are employed as required 
Abnormal/unusual conditions are monitored and addressed 
Variations to activity conditions are implemented as required 
Handover/takeover procedures for control of synthetic device are implemented in accordance with workplace procedures 
Trainee progress is monitored and documented in accordance with workplace procedures 
Trainee cognitive load is assessed, monitored and managed 
Support and guidance are provided within synthetic environment as appropriate 
Trainee is encouraged to develop self-assessment skills 
Trainee interaction with others and participation in synthetic training activities is continuously monitored, and interventions are made as required 
Opportunities are provided for trainees to reflect on their learning progress 
Significant details of trainee performance are clearly and accurately debriefed 
Playback devices are employed during debriefing to illustrate key learning points as required 
Trainee is briefed on details of next training event as required 
Trainee records are maintained in accordance with workplace procedures 
Relevant stakeholders are kept informed about trainee progress 
Synthetic device faults are recorded and/or rectified in accordance with workplace procedures 
Support and guidance are provided post synthetic environment activities as required 
Synthetic training session outcomes are evaluated against desired session outcomes 
Review is undertaken post-completion of learning program, course or qualification 
Time is taken to reflect on own performance as a trainer or facilitator, and ways to improve performance are explored 
Recommendations for improvements in facilitating training and appropriateness of synthetic systems, tools and resources are identified and documented, and discussed with relevant personnel for future action 

Forms

Assessment Cover Sheet

AVIM5004 - Facilitate training in a synthetic environment
Assessment task 1: [title]

Student name:

Student ID:

I declare that the assessment tasks submitted for this unit are my own work.

Student signature:

Result: Competent Not yet competent

Feedback to student

 

 

 

 

 

 

 

 

Assessor name:

Signature:

Date:


Assessment Record Sheet

AVIM5004 - Facilitate training in a synthetic environment

Student name:

Student ID:

Assessment task 1: [title] Result: Competent Not yet competent

(add lines for each task)

Feedback to student:

 

 

 

 

 

 

 

 

Overall assessment result: Competent Not yet competent

Assessor name:

Signature:

Date:

Student signature:

Date: