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    Request For Academic Records Authorization

    Uploaded by

    Ravi Shankar
    This document is a request form for academic records to be sent to the International Credential Evaluation Service (ICES). The top section is for the applicant to complete with their details and authorization to release records. The bottom section is for the authorized official at the applicant's academic institution to complete with confirmation of attendance details, attach the official academic transcript or statement of marks, and return using the provided mailing address. The official should sign and seal the envelope containing the confidential academic records.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Request For Academic Records Authorization

    Uploaded by

    Ravi Shankar
    1K views1 page
    This document is a request form for academic records to be sent to the International Credential Evaluation Service (ICES). The top section is for the applicant to complete with their details and authorization to release records. The bottom section is for the authorized official at the applicant's academic institution to complete with confirmation of attendance details, attach the official academic transcript or statement of marks, and return using the provided mailing address. The official should sign and seal the envelope containing the confidential academic records.

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    Ices

    Original Title

    Request for Academic Records Authorization

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    This document is a request form for academic records to be sent to the International Credential Evaluation Service (ICES). The top section is for the applicant to complete with their details and authorization to release records. The bottom section is for the authorized official at the applicant's academic institution to complete with confirmation of attendance details, attach the official academic transcript or statement of marks, and return using the provided mailing address. The official should sign and seal the envelope containing the confidential academic records.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    1K views1 page

    Request For Academic Records Authorization

    Uploaded by

    Ravi Shankar
    This document is a request form for academic records to be sent to the International Credential Evaluation Service (ICES). The top section is for the applicant to complete with their details and authorization to release records. The bottom section is for the authorized official at the applicant's academic institution to complete with confirmation of attendance details, attach the official academic transcript or statement of marks, and return using the provided mailing address. The official should sign and seal the envelope containing the confidential academic records.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Request for Academic Records

    International Credential Evaluation Service (ICES)

    Note to Applicant: It is the responsibility of individual applicants to have their academic records forwarded to ICES. Please
    complete the top part of this form and submit it to the registrar/controller of examinations/or other authorized official at the
    academic institution where you obtained your credential(s). Print additional copies of this form if necessary. Please note that
    some institutions may charge a fee for this service.
    ICES Ref # (if applicable)
    A 0
    Last/Family Name First/Given Name

    Previous Name (if applicable) Date of Birth (month/day/year) Email

    Institution Name Dates Attended


    From: To:
    (month/year) (month/year)
    Degree Name (if applicable) Year of Award (if applicable) Major

    Student ID or Roll Number at sending institution (if applicable)

    I hereby authorize the release of my academic records to the International Credential Evaluation Service (ICES).

    Applicant’s Signature: Date:

    Note to Authorized Official: The above-named person seeks to have his/her credentials evaluated and requests that a
    transcript of his/her academic records/statement of marks – showing all subjects completed and all grades/marks awarded
    for all years of study – be released to ICES. Please complete this form, place the form and academic record in an envelope,
    sign and seal the envelope across the back flap, and send it directly to ICES at the address below.
    Name of Official Completing Form (Please type or print) Title

    Address

    City Country Postal Code

    Telephone Fax

    Email URL
    www.

    Confirmation: I confirm that the student named above attended


    Institution Name
    Dates of attendance From To
    month/year month/year
    Date credential awarded
    (if applicable) month/year

    Authorized Signature and SEAL Date


    Yes, the applicant’s academic transcript/statement of marks is attached to this form.

    By Postal Mail: International Credential Evaluation Service (ICES)


    3700 Willingdon Avenue
    Burnaby, BC
    Canada V5G 3H2
    (PLEASE RETURN THIS FORM TOGETHER WITH THE OFFICAL ACADEMIC RECORDS/STATEMENT OF MARKS.)

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