American Service Center for

International Students and Scholars, Inc.

Specialized in Foreign Credential Evaluation & Information Services

 

Credential Evaluation Application 

Last (family) Name:

 First Name:

Middle Name:

 Previous Used Names:

U.S. Social Security Number:

 Mailing Address:

City:

 Zip/Postal Code:

State/Province:

 Country:

Work Phone:

 Evening Phone:

FAX:

 E-mail:

Place of Birth:

 Citizenship: 

Country of education received:

 
Purpose of Evaluation
Education Field of Study & Desired Institution:
Immigration Visa/Position:
Employment Field:
Licensing Field:
Teaching Degree:
Other Specify:
 
Types of Evaluation Requested: (Check the type of service and fill in the amount)
General (Document by document) $60
Course by Course $110
Licenses $220
Teacher Certification $220
Course Analysis and Catalog Match $20/course
Translation (Chinese only) $50/document 
 
Types of Service Requested: (Check the type of service and fill in the amount)
Same Day Service $150
2-day Service $100
3-day Service $80
5-day Service $50

Overnight Delivery Service within US  or Canada

 $15

Overnight Delivery Service outside US or Canada

 $50
Certified Mail Service $20
Additional Report $10/report
 
Evaluation Report Mailing Instructions:
Please mail both copies of the evaluation report to the address above.

Please mail one copy of the evaluation report to the address above and another  copy to:  
Additional copies requested at $10/copy. Please provide mailing addresses.
 
Payment: (payment must be made in U.S. dollars)

Money Order    * Make checks / money orders payable to International Students &  Scholars Services, Inc.    
Check
 
Please provide the following documentations:
The completed application form with your signature.
Copies of all official educational records in the original language and their English translation.    
Chronicle list of your education and work experience with dates of attendance/employment.    
Others:  Specify:
 
Affirmations:

  • I certify that the information submitted on behalf of the evaluation is true and correct.

  • I certify that I have read the instructions and conditions and agree to the terms stated herein.

  • I understand that evaluation reports prepared by International Students and Scholars Services, Inc. are advisory in nature and are not binding upon any agency or institution.

  • I release International Students and Scholars Services, Inc. from any liability for damages resulting from the use of an evaluation report by me or any other third party.
Signature:   

    Printed Name:          
(Signature is required to start the process)
Today’s Date  (Mo/Day/Yr):    

 

 

 

P.O. Box 250, Hunt Valley, Maryland 21030  USA

Phone: (410) 785-3696    Fax (410) 785-6638

E-Mail: service@asciss.org             Website: www.asciss.org