APPLICATION for Evaluation of International Educational Credentials
Service Options Please first read pages 1 and 2 of this application.
Primary Purpose of Evaluation
Education
Employment
Immigration
Professional Licensing/Certification: Field ________________________________________ State __________________
Basic Evaluation Fees — Choose one. See page 1 for details.
Document-by-Document ($100)
Comprehensive Course-by-Course ($160)
CPA Board Evaluation ($200)
Rush Services — Optional
Same-day (add $195)
Three-day (add $100)
Additional Reports ($20 each) Number requested ___________ x $20 = $ ___________
Sealed Envelope Option: Additional reports ordered above sent in sealed envelope(s) (add $7)
Delivery Options
Evaluation report sent to me:
Overnight (U.S./Canada) (add $25)
2nd Day Air (U.S. Only) (add $15)
International Express (add $50)
Fax (add $5)
Other reports sent:
Overnight (U.S./Canada) (add $25)
2nd Day Air (U.S. Only) (add $15)
International Express (add $50)
TOTAL AMOUNT — Add the amounts for all items checked above. $ ________________________
Payment Options
❏ Check / Money Order Enclosed (Payable to World Education Services)
❏ Charge my: (Check one) ❏ VISA ❏ MasterCard ❏ American Express ❏ Discover
Credit Card Number _______________________________________________________________________________________ Exp. Date _____________________________
Signature of Cardholder (required) _________________________________________________________________________________________________________________
Cardholder Name and Billing Address (if different than applicant) _______________________________________________________________________________________
Personal information Please print or type.
Name _________________________________________________________________________________ Previous/Maiden Name _____________________________________
Last/Family First/Given Middle If appearing on any of your academic credentials.
Mailing Address ____________________________________________________________________________________________________________________________
Number and Street Apt./Flat Number
__________________________________________________________________________________________________________________________________________________
City State/Province Country Zip/Postal Code
Phone __________________________________ Fax __________________________________ E-mail ______________________________________________________________
Preferred Method of Contact:
Mail
Fax
E-mail
Date of Birth (Month/Day/Year) ____________________________________
Male
Female Social Security Number ________________________________________
Have you ever submitted an application to WES?
Yes
No If yes, provide WES Ref.# _________________________________________________________________
How did you hear about, or who referred you to WES? ____________________________________________________________________________________________________
List all educational institutions attended, beginning with secondary school and including the one you are currently attending.
Name of Institution Country Dates of Attendance Name of Diploma/Certificate Year of
From To (in original language) Graduation
a. ____________________________________________ ______________________ __________________________ ________________________ _____________
b. ____________________________________________ ______________________ __________________________ ________________________ _____________
c. ____________________________________________ ______________________ __________________________ ________________________ _____________
□ I have read the documentation requirements for my country of education at
<www.wes.org/required>
and agree to submit my credentials as instructed.
Send An Evaluation Report To
If you want a copy of the report sent to an academic institution, employer, or licensing board, please indicate their exact name(s) and address(es) below.
Attach additional sheet if there are more than 2 addresses.The first report is free of charge if ordered with this application. (See page 1 for details.).
1. ______________________________________________________________________ 2. _____________________________________________________________________
______________________________________________________________________ _____________________________________________________________________
______________________________________________________________________ _____________________________________________________________________
______________________________________________________________________ _____________________________________________________________________
City State Zip City State Zip
I certify that:All of the information provided in the application is correct; I have read all the instructions and policies provided on pages 1 and 2 of this
application and agree to the terms stated therein; I understand that the report is advisory and not binding upon any agency or institution that uses it.
I understand that fees are not refundable once an application is submitted. Finally, I release World Education Services from any liability for damages
resulting from the use to which I or any agency or institution puts the evaluation report.
____________________________________________________________ ____________________________________________________________ _______________________
Name (printed) Signature Date
www.wes.org
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