Request of Academic Records
This form should be used to request the release of academic records by an academic institution. Each applicant needs to contact the
academic institution directly. Please fill-in Section A and submit the form to the registrar or other authorized authority in the institution
where you received your credential(s).
Section A (For applicants)
Previous Last/Family Name (if applicable)
First Name
Dates Attended: From To: Year Awarded:
Student ID at the Institution: IQAS Reference Number:
I hereby authorize the release of my academic records to the International Qualification Assesment Service (IQAS).
Applicant’s signature: _____________________________________ _Date: ___________________
Section B (For authorized officials)
The person named above requests that the academic records be released to International Qualification Assessment Service (IQAS).
The released records should show all subjects completed and all grades/marks awarded for all years of study. Please complete this
form, package it with the academic record(s) in a sealed envelope that is signed and stamped with the institution’s official seal across
Institution Name
Degree Awarded
First and Last Name of official completing the form (please print)
Program length
Title
Telephone
The academic records are enclosed with this form: Yes
Authorized signature ____________________________ Seal: ______________________ Date: _________________
Please send the package to: International Qualifications Assessment Service (IQAS)
9th floor, 9942 108 Street
Edmonton, AB T5K 2J5 Canada
