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Application for Evaluation of Foreign Educational Credentials For

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01/04/2021
Josef Silny & Associates, Inc.
International Education Consultants
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
For Applicants to Graduate Admission to Kennesaw State University
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 that transcripts or examination results be sent
directly 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.
Company Contact
Information
Website Link
01/04/2021
TYPES OF EVALUATIONS
GRADUATE APPLICANTS
Must request the Course-by-Course Evaluation with the grade point average. An official original transcript with names of courses, credits
or hours of instruction, and grades must be submitted. Students who already graduated must also submit an official original degree.
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. University Course-by-Course + G.P.A. - U.S. $160
2. 24-Hour Evaluation - U.S. $150 in addition to the basic fee
3. 2-Day Evaluation - U.S. $100 in addition to the basic fee
4. 5-Day Evaluation Report - U.S. $50 in addition to the basic fee
5. 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. $160.
6. 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 $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.
7. 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.
8. The applicants are responsible for any verification fees charged by their universities.
INFORMATION 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.
01/04/2021
Graduate
PERSONAL INFORMATION
Gender:
Male Female
Pleas
e use your name exactly as it appears on your passport.
Full na
me:
Last name First name Middle name Maiden name
Addres
s:
Street Address Apartment Number
City State Zip code Country (if not U.S.)
Date o
f birth: Country of citizenship: Country of birth:
Month / Day / Year
Tele
phone: Fax: E-mail:
Area code and number Area code and number
Type of Professional Service Requested:
Basic Fees
University Course-by-Course + GPA (U.S. $160 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
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. $
Translation (quote provided upon request) U.S. $
Other U.S. $
Have you used JS&A services previously? Translation: No: Yes: Date:
Evaluation: No: Yes: Date:
ONE EVA
LUATION REPORT WILL BE SENT ELECTRONICALLY TO KENNESAW STATE UNIVERSITY
ACADEMIC H
ISTORY
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.)
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.
Date:
Name of Institution
City, Country
Attendance
From - To
Diplomas or Certificates
Year of
Graduation
1.
2.
3.
4.
5.
6.
7.
-
-
-
-
-
-
-
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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signature
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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, 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
Massage Therapy: Florida, Nevada, Utah
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: Alabama, Arizona, Colorado, Florida, Hawaii, Missouri, Montana, Nebraska, New Hampshire, New Mexico, Oregon,
Puerto Rico, Texas, 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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Completed 5 January 2022

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