Examples of Witness Statements


Lesson Plan and Record (EXAMPLE)




Entry Level 2 (Week focus underlined in bold). Date:




Student’s Name:




Student Unique Reference Number:




Unit Outcomes:

201 Conversation skills:

Responds to partner’s conversation opening with known partners in routine situations and a familiar environment.

  1. Recognise other’s wish to communicate
  2. Respond to other’s opening communication






Notes on Lesson outcomes:

WS links (if any)








Lesson Plan:




















Notes for Witness Statements arising out of session:




















City and Guilds




Effective Augmentative and Alternative Communication




Witness Statement Entry Level: ___________








Candidate Name: ___________________ Date and time: ________




Unit: Unique Reference no:




Learning Objective:




Context (where the communication took place and what was happening)




Exact words (of all people involved)







Style of production i.e. verbal, signs, gesture, VOCA




















Name of witness: Position held:




Signature: Video Number:












Assessor’s signature: Date:




Thank you