FRM/EDPD/107
C A R I B B E A N E X A M I N A T I O N S C O U N C I L
                                                                CARIBBEAN SECONDARY EDUCATION CERTIFICATE®
                                                                                                                                                             For CXC use only
                                                                          MODERATION OF SCHOOL-BASED ASSESSMENT                                              Teacher I.D. No.:
                                                                                         INTEGRATED SCIENCE
        NAME OF CENTRE:                                                                                                                CENTRE CODE:
        NAME OF TEACHER:                                                                                                               NUMBER OF CANDIDATES IN CENTRE:
        TERRITORY:                                                                                                                     YEAR OF EXAMINATION:
                                                                                                                            PRACTICAL SKILLS                         PROFILE TOTAL
                                                                                                               Obs./Rec./             Manip./ Plan./    Analysis &    (Teacher score as OVERALL
       Registration                                                                               ASSESSOR     Rep.         Draw.     Meas.   Design.   Interpr.     entered in the ORS) TOTAL
                                   Candidate’s Name (from sample generated in the ORS)
        Number                                                                                                  P3 (20)     P3 (10)   P3 (20) P3 (20)    P2 (30)     P2 (30)     P3 (70)   100
                                                                                                  Teacher
  1.                                                                                              Moderator
                                                                                                  Teacher
  2                                                                                               Moderator
                                                                                                  Teacher
  3.                                                                                              Moderator
                                                                                                  Teacher
  4.                                                                                              Moderator
                                                                                                  Teacher
  5.                                                                                              Moderator
NAME OF TEACHER: _________________________________________________                                      SIGNATURE OF TEACHER:_____________________________ DATE:______________________________
NAME OF PRINCIPAL/HOD: ____________________________________________                                     SIGNATURE OF PRINCIPAL/HOD:_______________________ DATE:_______________________________
MODERATOR’S INITIALS:                             CHIEF MODERATOR/LOCAL REGISTRAR INITIALS:                                                                    DATE :
  Revised: March 2025
                                                                      To be sent to the Local Registrar for submission to CXC