Scribd
Upload
181 views1 page

Request For Academic Records Authorization

This document is a request form for academic records from the International Credential Evaluation Service. It collects information such as the applicant's name, date of birth, institution attended, dates of attendance, degree earned, and student identification. The applicant authorizes the release of their academic record to ICES. The form instructs the authorized official at the applicant's institution to complete the form, include the applicant's academic transcript or statement of marks, seal it in an envelope, and send it directly to ICES.

Uploaded by

ISHU ISHU
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
181 views1 page

Request For Academic Records Authorization

This document is a request form for academic records from the International Credential Evaluation Service. It collects information such as the applicant's name, date of birth, institution attended, dates of attendance, degree earned, and student identification. The applicant authorizes the release of their academic record to ICES. The form instructs the authorized official at the applicant's institution to complete the form, include the applicant's academic transcript or statement of marks, seal it in an envelope, and send it directly to ICES.

Uploaded by

ISHU ISHU
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 1

REQUEST FOR ACADEMIC RECORDS

International Credential Evaluation Service


3700 Willingdon Avenue, Burnaby, BC, Canada V5G 3H2
F 604.435.7033
CLEAR FORM

Instructions: 1) Save this PDF to your desktop, 2) Open with Adobe Reader or Adobe Acrobat, 3) Complete all required fields,
4) Save, 5) Close PDF then re-open to ensure the content you filled in has saved, 6) Submit to BCIT.

ICES Ref # (if applicable)


A0
Last/Family Name First/Given Name

Previous Name (if applicable) Date of Birth (mm/dd/yyyy) Email

Institution Name Dates Attended


From To
Degree Name (if applicable) Year of Award (if applicable) Major

Student ID or Roll Number from the Sending Institution (if applicable) Mode of delivery
 Regular / On campus  Distance education

I hereby authorize the release of my academic record to the International Credential Evaluation Service (ICES)
Applicant’s Signature Date

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

Address

City Country Postal Code

Telephone Fax

Email URL

CONFIRMATION

I confirm that the student named above attended:


Institution Name Dates of Attendance
From To
Date Credential Awarded (if applicable) (mm/yyyy)

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
By email: [email protected]

PLEASE RETURN THIS FORM TOGETHER WITH THE OFFICIAL ACADEMIC RECORDS/STATEMENT OF MARKS.

ICES-4_V1 (2020:06)

You might also like