NEBOSH International General Certificate

in Occupational Health and Safety

UNIT GC3: HEALTH AND SAFETY PRACTICAL APPLICATION

Student Name:

Student Number:

Date of Submission:
APPENDIX 1
GC3 – The Health and Safety Practical Application

Candidate and course provider declarations:

For completion by the candidate:

I declare that the work submitted for this practical application assessment i.e. the completed observation sheets and
the report to management, is my own work. 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

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 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 _______________________________

For completion by the course provider’s 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
candidate’s script. If this declaration is not submitted the candidate’s result may be
declared void.
APPENDIX 3
INTERNATIONAL GENERAL
CERTIFICATE Assessor’s marking sheet
(2011 specification)
GC3 – THE HEALTH AND
SAFETY PRACTICAL APPLICATION
Date of practical application (Write the Date of GC2 Examination) Name of assessor:

Course provider Course provider Redhat safety training and consulting Pvt
number
1120 name Ltd

Student number Student name

NEBOSH
Maximum
Assessor’s moderated
marks
Criteria available
marks awarded marks
(if different)

1 Completion of observation sheets

1.1 Range and outline of hazards and consequences 15

Identification of suitable control measures and

1.2 15
timescales

2 Report - Introduction and Executive Summary

Introduction providing an overview of the chosen

2.1 5
area

2.2 Executive summary 5

3 Report - Main findings of the inspection

3.1 Quality of interpretation of findings 15

Identification of possible breaches of international

3.2 5
standards

3.3 Persuasiveness / conciseness / technical content 10

4 Report - Conclusions and Recommendations

Clear and concise conclusions which are clearly

4.1 related to report findings and are effective in 15
convincing management to take action

Recommendations which present realistic actions to

4.2 15
improve health and safety in the chosen area

TOTAL MARKS
100

Grades:
Outcome: PASS (60% or more) REFER (less than 60%)

Date assessed ____ / ____ / ____

Assessor’s signature ______________________

Date received by course provider ____ / ____ / ____

Date received by NEBOSH

(if applicable) _____ / _____ / _____

Assessor’s additional comments on the practical application:

ASSESSED BY (name in block letters) ________________________________________________

The mark sheet must be retained by the Course Provider and sent to NEBOSH only if requested.

NEBOSH USE ONLY

NEBOSH Moderator’s comments:

APPENDIX 4

GC3 – THE HEALTH AND Candidate’s observation

SAFETY PRACTICAL APPLICATION sheet

Sheet number of _____

Student name _______________________________________ Student number _________________

Place inspected _____________________________________ Date of inspection ___ / _____ / _____

Observations Control measures Timescale

Hazards and consequences Immediate and longer term actions
APPENDIX 5

UNIT GC3 – THE HEALTH AND Candidate report template

SAFETY PRACTICAL APPLICATION

Student number ________________________________

Location ______________________________________ Date of review / /

Introduction including overview of area inspected and activities taking place

APPENDIX 5

UNIT GC3 – THE HEALTH AND Candidate report template

SAFETY PRACTICAL APPLICATION

Student number ________________________________

Location ______________________________________ Date of review / /

Executive Summary
APPENDIX 5

UNIT GC3 – THE HEALTH AND Candidate report template

SAFETY PRACTICAL APPLICATION

Student number ________________________________

Location ______________________________________ Date of review / /

Main findings of the inspection

APPENDIX 5

UNIT GC3 – THE HEALTH AND Candidate report template

SAFETY PRACTICAL APPLICATION

Student number ________________________________

Location ______________________________________ Date of review / /

Conclusions
APPENDIX 5

UNIT GC3 – THE HEALTH AND Candidate report template

SAFETY PRACTICAL APPLICATION

Student number ________________________________

Location ______________________________________ Date of review / /

Recommendations – include as a table in the following format:

Recommendation Likely resource implications Priority Target date