APPLICATION FOR EVALUATION OF INTERNATIONAL EDUCATIONAL CREDENTIALS

Please retain the top page of this application form for your records.

Address: P.O. Box 514070 Milwaukee WI 53203-3470 USA Phone: 414.289.3400 Website: www.ece.org Email: eval@ece.org

1. General Procedures
To begin work on an evaluation report, we must receive the following: A completed ECE application form including signature All academic credentials to be evaluated (you must visit the ECE website www.ece.org to determine the documents you are required to send to us based on the country or countries of study.) Payment in full for the evaluation report ordered and any additional services ordered You are responsible for submitting to us all required documents and correct payment. Failure to submit all required documentation, information and payment will delay the evaluation report process. Errors in a report based on incorrect or incomplete information submitted will not be corrected by us after the report is issued unless an additional fee is paid. The name provided in the Applicant Information section of this form will appear on the completed report. We will not revise a completed evaluation report to incorporate name changes or variations. Payment must be made in U.S. dollars by money order, certified check, Visa, or MasterCard. If the money order or check is issued by a bank outside of the U.S., it must contain the printed name of the U.S. bank with which the bank is affiliated. A $40 fee will be charged for all returned checks. We cannot accept bank drafts or cash. There are no refunds once an application form has been submitted.

2. Educational Documents
Documentation requirements and the method that must be used to submit the educational documents to us vary based on the country of study and the purpose of the evaluation report. You must visit www.ece.org to determine the documents you are required to submit and how you must submit them based on the country or countries of study. If you do not have access to the internet, contact us so that we can mail this information to you. If you plan to submit the evaluation report to a specific institution (university, licensing board, employer, etc.) contact that institution to determine which type of report it requires and any special requirements it may have. If necessary, you may contact us for additional assistance determining which type of report would best meet your needs and any special requirements of the U.S. institution that will receive the report. We will return all original documents that you submit to us for evaluation. If you do not arrange for courier service return of your original documents, we will return them via regular mail. You will have the option to track the status of the package only if you select courier service. The following items become our property and will not be returned: Photocopies of educational credentials English translations Documents sent directly to us by international schools or examination boards, and other institutions Study plans, course descriptions, etc. (including those issued by institutions)

3. Processing and Delivery Time

Most evaluation reports are completed within one month. However, the time it takes to complete an evaluation report may vary. Visit www.ece.org for more information about our processing time when you order an evaluation report. We also offer three types of rush service: 1-business day (available for General reports only); 5-business days; and 12-business days. Business days are Monday through Friday and do not include public holidays or weekends. The evaluation process for all reports, including those with rush service, will not begin until we receive all required information, fees, and educational credentials. Processing time does not include delivery time which may vary depending on your location. The evaluation report will be delivered to the person who orders the report. Official copies of the report in a sealed envelope may be ordered for an additional fee and delivered to an address of your choice in the Additional Report Copies section. You are responsible for providing us with accurate and valid mailing addresses and for reporting to us any change of address or contact information. Failure to report a change of address to us may delay delivery of the completed report.

4. Requests for Additional Information and Verification

We reserve the right at any time during the evaluation process to request additional information and/or original educational documents. Requests for additional information and documentation will increase processing time. We may require you to make arrangements to have documents sent directly to us by the school, institution or examination board. We also reserve the right to contact educational and governmental institutions to verify the authenticity of documents submitted for evaluation. Document verification may significantly delay the evaluation process. No evaluation report will be prepared and no refund will be made in the event that we receive confirmation that educational credentials submitted for evaluation are not authentic.

5. Terms and Conditions

1) Equivalency conclusions stated in our evaluation report reflect our judgment based on in-depth research in applied comparative education. 2) We guarantee that each evaluation report will be prepared by our qualified professional staff. We do not guarantee that you, an agency, or any third party will agree with our educational equivalence recommendations. We assume no responsibility for judgments or opinions made by an individual, agency or third party based on our equivalence recommendations. 3) We reserve the right to refuse service to anyone. 4) We do not guarantee processing time and assume no liability related to the delay in the preparation and delivery of an evaluation report. 5) If we determine that the education completed is not the equivalent of U.S. university-level study offered at a regionally-accredited institution in the United States, a General Evaluation Report will be prepared. If any report other than the General Evaluation Report was ordered, the difference in fees between the report ordered and the General Evaluation Report will be refunded. 6) Education is dynamic and changes occur in all countries. Our ongoing research may identify new equivalents for certain credentials from other countries, resulting in different statements of equivalence than were provided prior to the completion of such research. It is understood that all previous evaluation reports will have been based on the best information available to professionals in the applied comparative education field in the United States at that time. If copies of an evaluation report are requested at a later time, we have no obligation to review or revise the report in accordance with any changes that may have occurred in the interim.

Applicant Information (Person whose credentials will be evaluated)

Name (Please print): ___________________________________________________________________________________________________________
(last or family name) (first name) (middle name)

Name on educational document(s) [if different from the name above]: _________________________________________________________________ Country of Study ______________________________________ Birthdate: day ________ month _____________ year _________ Male Female
Have arrangements been made to have educational documents sent directly to us by the international school? No Previous reference number: Yes

No Yes - provide the reference number: ____________________________ (Enter N/A if not available)

Your mailing address

[The evaluation report will be delivered to the person who orders the report at the address provided below. To order official copies of the report in a sealed envelope to be delivered to another destination, see Additional Report Copies section] ____________________________________________________________________________________________________________________________ (number & street) (apt. #) ____________________________________________________________________________________________________________________________ (city & state) (zip or postal code) (country)

E-Mail ________________________________________ (Provide your email address in order to receive updates on the status of your evaluation report.) Phone
Primary: ( _______ ) _______________________________________ Alternate: ( _______ ) ______________________________________

Educational History
Provide a complete and accurate educational history, starting with the first year of secondary school and ending with any current enrollment. Print the name of each educational document in English and the native language. Attach additional sheets if necessary. Do not omit any studies. We will require a new application form and payment to evaluate at a later date any studies not reported.

Name of Institution
_______________________________

City & Country

_____________________________

Dates of Attendance
___________ to___________ month/year month/year ___________ to___________ month/year month/year ___________ to___________ month/year month/year ___________ to___________ month/year month/year

Degree/Diploma/Certificate
______________________________

Graduated?
(circle one)
Yes No

_______________________________

_____________________________

______________________________

Yes

No

_______________________________

_____________________________

______________________________

Yes

No

_______________________________

_____________________________

______________________________

Yes

No

Explain any gaps in education or special circumstances: _____________________________________________________________________________________________________________________________________

Evaluation Report Purpose (check all that apply)

Education
Freshman =Undergraduate or Transfer =Graduate I am applying to the following institution(s): __________________________________________________ Field of Study: _____________________________ [You must complete the Additional Report Copies section of this application form if you want us to send an official copy of the report to this or any other institution.] Professional Licensure Profession: _________________________________________________________________________ State: _____________________________________ Employment Immigration Military Other: __________________________________________________________

Evaluation Report Types

Type of Report General
Not recommended for the purpose of education

Report Description

Suggested Uses

U.S. educational equivalence for each educational credential beginning with Immigration; Professional Licensure the final year of high school Does not include a grade average U.S. educational equivalence for each educational credential beginning with Education; Professional Licensure; the final year of high school Employment Grade average for U.S. equivalent university-level credentials Grade average for high school level study if no U.S. equivalent universitylevel study was completed

General with Grade Average

Course by Course

U.S. equivalence for each educational credential, beginning with the final Education; Professional Licensure; year of high school Employment Credit and grade equivalents for each U.S. equivalent university-level course Grade average for each U.S. equivalent university-level credential Identifies upper level courses for U.S. equivalent undergraduate studies General evaluation of high school level credentials (without a grade average) if any U.S. equivalent university-level study was completed U.S. unit and grade equivalents for each high school level course, if no U.S. equivalent university-level study was completed Grade average for high school level credentials, if no U.S. equivalent university-level study was completed U.S. equivalence for each educational credential, beginning with the final year of high school Credit and grade equivalents for each U.S. equivalent university-level course Grade average for each U.S. equivalent university-level credential Identifies upper level courses for U.S. equivalent undergraduate studies U.S. unit and grade equivalents for each high school level course Grade average for high school level credentials Education; Professional Licensure; Employment

High School and University Level Course by Course

You must submit high school and university level documents for this report

The reports below can be prepared only when we have received specific instructions beforehand from the agency or institution that requires the report.

Subject Analysis

U.S. equivalence for each educational credential, beginning with the final year of high school Credit and grade equivalents for each U.S. equivalent university-level course Information regarding the content of university-level courses, as specified by the agency or institution requiring the report Grade average for each U.S. equivalent university-level credential Identifies upper level courses for U.S. equivalent undergraduate studies General evaluation of high school level credentials without a grade average U.S. equivalence for each educational credential, beginning with the final year of high school Credit and grade equivalents for each U.S. equivalent university-level course Grade average for each U.S. equivalent university-level credential Identifies upper level courses for U.S. equivalent undergraduate studies General evaluation of high school level credentials without a grade average Match of each U.S. equivalent university-level course to a U.S. institution's course catalog code U.S. equivalence for each educational credential, beginning with the final year of high school Credit and grade equivalents for each U.S. equivalent university-level course Grade average for each U.S. equivalent university-level credential Identifies upper level courses for U.S. equivalent undergraduate studies General evaluation of high school level credentials without a grade average Categorization of each U.S. equivalent university-level course according to the guidelines specified by a health professions licensing board

Education; Professional Licensure; Employment

Catalog Match

Education

Health Professions Licensure

Florida Department of Health, Dental Hygiene Licensure

Choose an Evaluation Report (choose only one report type by checking the appropriate box)
General General with Grade Average General with 1 business day rush service (includes two copies of the report) General with Grade Average

$85 $110 $275 $300

_____ _____ _____ _____

Course by Course High School and University Level

$140

_____

Course by Course

$175

_____

with 1 business day rush service

(includes two copies of the report) If you select either of the 1 business day rush reports, we will send one of the two copies via courier service to your mailing address or another address. Courier service is not available to P.O. Boxes. Send via courier to my address OR Send via courier to the address below:

The following specialized report types will only be prepared when required by the receiving institution. You must submit a syllabus or set of course descriptions for us to prepare these report types. If official course descriptions cannot be obtained, you may prepare them from memory: Subject Analysis $185 (Receiving Institution:_______________________) Catalog Match $235 (Receiving Institution:_______________________) Health Professions Licensure $250 (Receiving Institution:_______________________)

_____ _____ _____

__________________________________________________________ __________________________________________________________ __________________________________________________________

Report Subtotal: _______ See the Evaluation Report Types section for details of each type of evaluation report.

Optional Rush Services

All rush services begin on the date payment and all required documents are received by us.

Rush Services:

5 business days $80

12 business days $50

Subtotal: _______

Report Delivery Services

The evaluation report will be delivered to the person who orders the report at the address provided in the Applicant Information section. We normally mail evaluation reports via the United States postal service. Courier service with a tracking number is available for an additional fee. In limited cases, payment in addition to the standard ECE rate for courier service will be required. Any additional copies of the evaluation report that you order in the Additional Report Copies section below will be delivered via courier service if you select courier service to your mailing address. We recommend courier service for the return of original educational documents if you submit them to us for evaluation. Alternatively, you may send a pre-paid envelope for the delivery of the evaluation report and original documents.

Courier Service to your mailing address:

US and Canada Courier $35

International Courier $60

Subtotal: _______

Additional Report Copies

You may order additional copies of the report in a sealed envelope. We will deliver official copies in a sealed envelope to your home address or any other address you provide. Prices listed are per copy. Courier service fees are per address.
=Number of additional copy/copies of the report to your address =Number of additional copy/copies of the report to: _____ ($10 per copy) _____ ($10 per copy)

__________________________________________________________ __________________________________________________________ __________________________________________________________

=Add Courier Service to the address above: US and Canada Courier $35 International Courier $60 =I have attached a separate sheet for additional addresses and mailing instructions.

Send unofficial copy via fax: _____________________________________

(Receiving Institution) ______________________________________ (Receiving Institution)

_________________________________ $10 (Fax number) _________________________________ $10 (Fax number)

_______ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Subtotal: _____ ____

Payment Information
All payments are final. No refunds will be issued once an application has been submitted.
Check or Money Order (Made payable to: ECE) Credit Card

Name on Credit Card: ________________________________________________ Circle Credit Card type: MasterCard

VISA

Billing Address: __________________________________________________________________________________________________________ Card Number: ___________________________________________________ Expiration date: month ____________________ year ___________

Credit Card CVV code: __________________________________________ (3 digit security code from back of card) Cardholder Signature: _________________________________________ Cardholder Name Printed: ____________________________________
**By signing, I authorize Educational Credential Evaluators, Inc. to bill my credit card for the total amount of services selected above.**

______________________________________________________________
Certification
I certify that all of the information provided in the application is complete and correct to the best of my knowledge. I certify that I have read all of the information provided on the application form and I accept the terms and conditions stated therein. I understand that the information provided by Educational Credential Evaluators, Inc. on this application form (or on its website), including fees, is subject to change without notice. I understand that if false information or forged, altered, or falsified documents are submitted to Educational Credential Evaluators, Inc. at any time, no evaluation report will be prepared, no refund will be made, the designees for copies of the report will be notified, and the information will be shared with academic institutions, government agencies, professional organizations, and other evaluation services. All documents (original and photocopies) will become the property of Educational Credential Evaluators, Inc. and will not be returned. I understand that evaluation reports prepared by Educational Credential Evaluators, Inc. are advisory and are not binding on an institution, organization, or agency which may use them. I hereby release Educational Credential Evaluators, Inc. and its officers, employees and agents from any liability for any loss or damage I may sustain as a result of any actions or omissions of Educational Credential Evaluators, Inc., whether or not caused by the negligence of the released party, relating in any way to the services performed or failed to be performed by Educational Credential Evaluators, Inc., including but not limited to loss of any documentation submitted. By signing this Application I agree that any dispute relating to this Application or to the services performed or failed to be performed by Educational Credential Evaluators, Inc. shall be governed by Wisconsin law and shall be heard and resolved exclusively in state or federal courts located in Milwaukee County, Wisconsin (U.S.A.). I submit myself to the personal jurisdiction of such courts and waive my right to commence any suit, proceeding or claim in any other court or venue. I also waive my right to trial by jury. This application creates a contract between Educational Credential Evaluators, Inc. and the person who has signed the application. If the signer is not the person whose credentials are being submitted for evaluation, the act of signing certifies that the signer is acting on behalf of the person whose credentials are involved, and has the authority to do so.

TOTAL AMOUNT (add all subtotals): _________

Signature _______________________________________________________________________ Date ________________________________________ Name (Printed) _________________________________________________________________________________________________________________