Fillable Application for Evaluation of Foreign Educational Credentials

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Application for Evaluation of Foreign Educational Credentials

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12/10/2019
Company Contact
Information
Josef Silny & Associates, Inc.
International Education Consultants
Website Link
Mail applications to:
7101 SW 102 Avenue
Miami, FL 33173
Tel.: (305) 273-1616
Fax: (305) 273-1338/Translation Fax: (305) 273-1984
E-Mail: info@jsilny.org
Web Site: www.jsilny.org
Application for Evaluation of Foreign Educational Credentials
Information on Josef Silny and Associates, Inc., International Education Consultants (JS&A)
JS&A is an organization of highly qualified international education consultants. Mr. Silny is recognized nationally and internationally as an
expert in the field of foreign credential evaluations and international admissions. He has been the Director of International Admissions at the
University of Miami and the City University of New York. He has participated as a panelist or workshop director at national professional
conferences annually since 1974. He has held numerous committee chairmanships and memberships in national professional organizations and
corporations. Mr. Silny has published a book and numerous articles in the field of international education. All international education consultants
associated with Mr. Silny are highly qualified in the field of foreign credential evaluations. JS&A is a member of the National Association of
Credential Evaluation Services, Inc. (NACES)
APPLICATION PROCEDURES - Please be sure to read the complete information on our website at www.jsilny.org
PLEASE BE AWARE THAT WE WILL NOT PROCESS YOUR REQUEST FOR ANY SERVICE UNLESS WE RECEIVE YOUR FILLED-OUT
AND SIGNED APPLICATION AND CORRESPONDING FEES. JS&A WILL NOT BE RESPONSIBLE FOR DOCUMENTS SENT TO US.
In order to receive an evaluation, an applicant must provide the following:
1.
A completed Application for Evaluation of Foreign Educational Credentials signed by the applicant
2.
A non-refundable evaluation fee in U.S. dollars. Make the bank check or money order payable to Josef Silny & Associates, Inc. (We
cannot accept postal money orders or payments through Western Union). If you are paying by a credit card you must fill out the Credit
Card Information form. All evaluation fees, including fees for rush report, 24-hour report, grade point average equivalent, extra copies,
and translation are NON-REFUNDABLE.
3.
EDUCATIONAL DOCUMENTS:
a)
Official original diplomas and certificates in the original language
b)
Official original transcripts in the original language (names of courses, grades, and hours of instruction) for every year of study
c)
JS&A is not responsible for any loss, destruction or damage of any original diploma, certificate or documents of any kind.
It is the responsibility of applicants to submit the academic credentials which need to be evaluated.
4.
TRANSLATIONS: Documents in a language other than English must be accompanied by professional, certified English translations.
Translations supplement, but do not replace the original documents. JS&A offers professional certified translations. JS&A is a
Corporate Member of the American Translators Association. For further information on the JS&A Translation Service, call 305-273-
1616 or e-mail or fax your request for translation estimate along with all pertinent documents.
E-mail: translation@jsilny.org Translation fax: 305-273-1984
5.
Please note: a Syllabus of university studies (description of each course or subject studied) may be required for Course-by-Course
Evaluations, but you do not need to send this with your application. If it is needed, JS&A will request it.
Processing Information: Josef Silny & Associates, Inc. reserves the right to request to review original documents and may insist that
transcripts or examination results be sent directly and verified by the issuing institutions or examination boards to JS&A. Academic
credentials received directly from foreign institutions are considered confidential and cannot be given to applicants. The documents you
submit with your application, with the exception of any originals, will become the property of Josef Silny & Associates, Inc. and they will
not be returned. Applicants who submit their own original academic documents must read page two of this application for information on
return of original documents by secure means. When it has been determined that documents submitted for evaluation or translation were
forged or altered in any way, no evaluation report or translation will be prepared and the fees will not be refunded. Fraudulent documents
will not be returned to the applicant. All recipients indicated on the application form will be notified. It is the applicant’s responsibility to
submit the documents which need to be evaluated. If the application is not completed within three months, JS&A will close the file. A new
evaluation fee will be required for updating the file. JS&A will keep applications with academic credentials for one year only. Please note
that all fees are subject to change without notice. Refusal of service: JSA reserves the right to refuse service to anyone.
In preparing an evaluation report, every effort is made to consult appropriate resources, in order to provide the most accurate evaluation
possible. JS&A will provide a list of the references used in making the specific evaluation upon written request.
12/10/2019
TYP
ES OF EVALUATIONS
A.
Document-by-Document - This evaluation names and describes all diplomas, certificates, degrees, periods of education or training
and gives a U.S. equivalent for each. This report is appropriate for freshman or graduate admission, for immigration purposes, for
military enlistment and for employment.
B.
University and Post-Secondary Course-by-Course - This evaluation provides the same information as the Document-by-Document
Evaluation, but also gives course, grade, and credit equivalents in U.S. terms for university level study in other countries. This type of
evaluation is usually required for transfer into a U.S. college or university. It is required for teacher certification, licensing or
membership in professional associations (Engineering, Midwifery, Nursing, Barber and CPA programs require separate evaluations).
C.
High School Course-by-Course – This evaluation lists high school courses taken, equivalent US high school units and equivalent US
grades. This evaluation is required for students transferring into high schools in the United States and it is sometimes required for
freshman admission.
It is the responsibility of applicants to request the type of evaluation and additional services they need.
PROCESSING TIME
1.
Standard Processing Time: Evaluations are normally prepared in ten working days from the receipt of all required fees, information
and documentation. Evaluations which require extensive research and correspondence may take longer to prepare.
2.
Rush Evaluation Reports
a)
24-Hour Evaluation Report b) 2-Day Evaluation Report c) 5-Day Evaluation Report
Rush evaluation reports will be completed in a timely fashion, in accordance with the type of rush evaluation report requested, upon
receipt of all required fees, information and documentation. If, for any reason, the evaluation report cannot be completed within the
specified time after receipt of all required fees, information and documentation, the rush fee will be refunded and the evaluation will be
completed as quickly as possible. The rush fee will be adjusted to reflect the actual processing time and a refund of the difference will be
issued. Rush evaluation reports must be paid for by bank check, money order or credit card.
COST OF EVALUATIONS
1.
High School Document-by-Document - U.S. $90
2.
University and Post-Secondary Document-by-Document - U.S. $90
3.
High School Course-by-Course - U.S. $150 (For transfer into US high schools and admission to some university programs).
4.
University and Post-Secondary Course-by-Course - U.S. $150 (For transfer admission and all licensing, except Engineering and Nursing).
5.
Accounting Course-by-Course - U.S. $190 - includes upper division ($190 for each additional State Board of Accountancy. Please indicate the
state).
6.
24-Hour Evaluation - U.S. $150 in addition to the basic fee
7.
2-Day Evaluation - U.S. $100 in addition to the basic fee
8.
5-Day Evaluation Report - U.S. $50 in addition to the basic fee
9.
Grade Point Average Equivalent - U.S. $40 in addition to the basic fee. (U.S. $40 for each level of education)
10.
Upper Division Course Identification - U.S. $30 in addition to the Course-by-Course Evaluation fee. (Required by some colleges, universities
and many boards of accountancy).
11.
High School Foreign Language Identification - U.S. $30 in addition to the basic fee
12.
Re-evaluation - Re-evaluations based on documents not submitted with the original request are considered new evaluations and a second
payment of the basic fee is required. When an applicant requests that a Document-by-Document Evaluation be changed to a Course-by-Course
Evaluation, the charge is U.S. $150.
13.
Extra evaluation reports - Additional original evaluation reports requested at the time of evaluation cost $20 each. Each evaluation report
requested after the evaluation has been completed costs U.S. $30 (evaluations may be available only within 3 years of the original date of
issuance). Please add U.S. $5 to the cost of each report that you wish to be mailed to you in a specially sealed JS&A envelope.
14.
Notarization of Copies of Original Documents - This service is provided for individuals applying to the Florida Department of Education’s
Bureau of Educator Certification or other agencies requesting notarized copies of original educational documents. The fee for this service is
U.S. $10 per document (diploma, transcript, etc.) Original documents must be presented with payment.
15.
Return of original documents by secure means:
Within the continental United States: - By Priority Mail: U.S. $20 per address
- By courier: U.S. $45 per address
Outside of the United States - By international courier: U.S. $85 per address
If the fee paid by the applicant does not cover the cost of the courier, we may use USPS Priority Mail Express instead.
Those in extended delivery areas will be billed for the balance of the fee.
JS&A accepts no liability for loss or damage of academic credentials during mailing.
16.
The applicants are responsible for any verification fees charged by their universities.
INF
ORMATION ABOUT EVALUATIONS
Method of Operation - To keep the cost of evaluations as low as possible, the evaluation service is conducted by mail. If there are
questions concerning an application, Josef Silny & Associates, Inc. will e-mail, write, or telephone the applicant. If the applicant requests
a personal interview, the charge will be U.S. $60 per half hour. Interviews are by appointment only.
Reassessment of Education Systems - Evaluations are based upon the best information and resources currently available to foreign
credential evaluators in the United States. Josef Silny & Associates, Inc. reserves the right to reassess educational systems as new and
additional information becomes available.
Satisfaction with Evaluations - JS&A guarantees that all evaluations are prepared by highly qualified evaluators, but it cannot guarantee
that the applicant will agree with the evaluation. Any questions or concerns about evaluations must be submitted in writing within one year
from the completion date.
JS&A does not accept courier
airbills filled out by applicants.
12/10/2019
PERSONAL INFORMATION
If you have a U.S. Social Security number, please list it: Gender:
Male
Female
Full name:
Last name
Maiden name
Address:
Full Street Address
Apartment number (if applicable)
City
State
Date of birth:
Zip code
Country of citizenship:
Country of birth:
Month / Day / Year
Telephone: Fax: E-mail:
Area code and number Area code and number
Type of Professional Service Requested:
Basic Fees
High School Document-by-Document (U.S. $90 basic fee)
Post-Secondary/University Document-by-Document (U.S. $90 basic fee)
High School Course-by-Course (U.S. $150 basic fee)
Post-Secondary/University Course-by-Course (U.S. $150 basic fee)
Course-by-Course for CPA (U.S. $190 basic fee)
Rush Fees
24-Hour Evaluation (U.S. $150 + basic fee)
2-Day Evaluation (U.S. $100 + basic fee)
5-Day Evaluation (U.S. $50 + basic fee)
Additional Services
High School Grade Point Average (U.S. $40 + basic fee)
Undergraduate Grade Point Average (U.S. $40 + basic fee)
Graduate Grade Point Average (U.S. $40 + basic fee)
Upper Division Course Identification (U.S. $30 + basic fee)
High School Foreign Language Identification (U.S. $30 + basic fee)
Extra Evaluation Report (U.S. $20 per report) How many?
Extra Report in Sealed Envelope (U.S. $25 per report) How many?
Secure Return of Originals U.S. $
Notarization Service (U.S. $10 per document) How many?
Translation (quote provided upon request) U.S. $
Other U.S. $
Please explain the purpose of the evaluation:
From whom did you learn of Josef Silny & Associates, Inc.:
Have you used JS&A services previously?
Translation:
No:
Yes:
Date:
Evaluation:
No:
Yes:
Date:
If you want your evaluation to be sent to an agency, employer, or educational institution (at U.S. $20/report), please list their names and addresses
below. If requesting more than 2 reports, please attach a sheet with additional addresses. Please specify method of delivery per address in the U.S.
(first address): First-Class Mail courier Priority Mail
1.
(second address): First-Class Mail
courier Priority Mail
2.
ACADEMIC HISTORY
Educational Institutions Attended (You must list all educational institutions you have attended. Begin with the first year of elementary school and include
any school you are now attending.)
Name of Institution City, Country
Attendance
From - To
Diplomas or Certificates
Year of
Graduation
1.
2.
3.
4.
5.
6.
7.
I, the undersigned applicant, certify and represent that all information provided in this Application is complete, factually accurate, and honestly presented, and that
I have read and understand the instructions and conditions (including that all fees are non-refundable). I agree to the terms stated herein. I understand that the
evaluation is advisory and is not binding upon any agency or institution that uses it. Further, in consideration of the payment by the undersigned applicant, and the
mutual undertakings by the parties as stated in this Application ("Agreement"), the undersigned applicant releases JS&A, its officers, directors, employees, and
agents, from any liability or damages resulting from: (a) the use to which I or any agency or institution puts the evaluation, and (b) for the loss of any original
documents. In addition, any litigation arising out of this Agreement will be under Florida law, and venue will be in Miami-Dade County, Florida. The prevailing
party to any litigation arising out of this Agreement is entitled to reasonable attorney's fees and all costs accrued during the litigation.
Signature of applicant: Date:
-
-
-
-
-
-
-
Country (if not US)
Method of delivery per address in the U.S.: First-Class Mail (no cost), by courier (U.S. $45), Priority Mail (U.S. $20)
Application must be signed by hand or digital signature (not typed).
By signing you agree to all terms on this agreement.
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6/05/2019
ORGANIZATIONS WHICH ACCEPT EVALUATIONS DONE BY JS&A
JS&A is a Member of the National Association of Credential Evaluation Services, Inc. (NACES). Evaluations prepared by JS&A are
accepted and recognized by the organizations listed below:
1.
U.S. Federal Government
The United States Citizenship and Immigration
Services
The United States Department of Agriculture
The United States Department of Defense
The United States Labor Department
The United States Office of Personnel Management
Federal Bureau of Prisons
Health Care Financing Administration
2.
U.S. Armed Forces
Air Force
Army
Marines
3.
Licensing Boards
Accounting: Arkansas, California, Colorado, Connecticut, District of Columbia, Florida, Guam, Indiana, Kentucky,
Michigan, Missouri, Nebraska, Nevada, New Mexico, Ohio, Pennsylvania, South Dakota, Tennessee, Utah, Vermont,
Virginia, Wisconsin, Wyoming
Architecture: Alaska, California
Barbers: Florida, Minnesota, South Dakota
Cosmetology: North Carolina, Tennessee, Utah, Vermont
Engineering: Alaska, Florida, Louisiana, Maryland, New Jersey, Puerto Rico, Texas, Virginia
Law: California, Florida, Texas
Marriage and Family Therapy, Mental Health: Florida
Medical Laboratory: American Medical Technologists, American Society of Clinical Pathologists, Health Care Financing
Administration, California, Connecticut, Florida, Georgia, Nevada, North Dakota, Tennessee
Midwifery: Florida
Nursing: Arizona, Florida, Hawaii, Missouri, Montana, Nebraska, New Hampshire, New Mexico, Oregon, Puerto Rico, Wyoming
Opticianry: Florida
Psychology: California, Delaware, District of Columbia, Florida, Maryland, Ohio, Oregon, Virginia
Respiratory Care: National Board for Respiratory Care, California, Florida
Speech-Language Pathology and Audiology: American Speech-Language-Hearing Association, Florida, Georgia
Texas Medical and Dental Schools Application Service
4.
State Departments of Education
Alabama, Alaska, Arizona, Arkansas, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Idaho, Illinois,
Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Mississippi, Missouri, Montana,
Nebraska, Nevada, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon,
Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington,
West Virginia, Wisconsin, Wyoming
5.
Other Governmental and Private Agencies
American Association for Clinical Chemistry
Association of Colleges of Osteopathic Medicine
American Association of Colleges of Podiatric Medicine
Association of American Veterinary Medical Colleges
Broward County Sheriff’s Office
CASPA - Central Application Service for Physician Assistants
Florida Department of Health and Rehabilitative Services
National Career Development Association
NCAA
Office of Personnel of: City of Miami, Ft. Lauderdale, Miami Beach, New York City, State of New York
6.
Hundreds of Colleges and Universities
Many other organizations which do not appear on this list may also accept evaluations done by JS&A. Applicants are advised to
check with the agency, institution, or organization to which they intend to submit the evaluation to make certain that the evaluation
will be recognized.
Josef Silny & Associates, Inc.
International Education Consultants
Tel.: (305) 273-1616
Fax: (305) 273-1338 / Translation Fax: (305) 273-1984
E-Mail: info@jsilny.org
Website: www.jsilny.org
CREDIT CARD INFORMATION
You must include the credit card holder’s copies of the front and back of the credit card and U.S. Driver’s
License OR Foreign Passport.
Name of Cardholder:
As it appears on the credit card
First Middle Last
E-mail address: _________________________________________ Phone No.: _________________________________________
Area code and number
Name of Applicant:
If different from the cardholder
First Middle Last
Billing Address:
Street address Apartment number (if applicable)
City State Zip code Country (if not U.S.)
I authorize Josef Silny & Associates, Inc. to charge my (check one):
VISA MASTER CARD DISCOVER
in the TOTAL amount of U.S. $
(TOTAL amount of your order must be filled in to process your payment.)
CREDIT CARD NUMBER:
3-digit security code on back of card:
Expiration Date (month/year):
Signature of Cardholder (Required): Date:
This signature authorizes Josef Silny & Associates, Inc. (JS&A) to charge the amount for the requested services in U.S.
dollars and the cardholder agrees to be bound by all Terms and Conditions (including that all fees are non-refundable)
as stated in the JS&A application.
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Application for Evaluation of Foreign Educational Credentials

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Completed 4 August 2020

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