EVALUATION:

APPLICATION

INTERNATIONAL UNIVERSITY LINE

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INTERNATIONAL UNIVERSITY LINE	For IUL	use only
P.O.Box 2525, La Jolla, CA 92038
Phone 858 457-0595 · Fax 858 581-9073
Email iul@iul-world.com

APPLICATION
FOR EVALUATION OF EDUCATIONAL CREDENTIALS

Purpose of Evaluation: Education Employment Immigration Licensing/Certification
(We do not provide evaluation for Registered Nurses or Medical Doctors for Licensing. You have to apply directly to Licensing Boards)

1. Name: _____________________________________________________________________
(Family name as it appears on your documents) (First) (Middle)

2. Address: ____________________________________________________________________________

3. If you want this evaluation mailed to an agency or another person, please give
address and name below:
____________________________________________________________________________

____________________________________________________________________________

4. Telephone: (_____)___________; Fax: (_____)____________; e-mail: ______________

5. Date of Birth ______/______/_______
(Month) (Day) (Year)

6. Male Female

7. Citizenship___________________ Country of Birth____________________________

8. EDUCATION: List ALL schools you have attended, beginning with primary school. Give exact dates and diplomas.

Institution Country, Location Dates Name of the Diploma Graduation Date

9. Name of institution where this evaluation will be used (optional)___________________
__________________________________________________________________________

Check all appropriate, please.
1. Diploma/Degree Equivalence: Associate and Bachelor only ($125.00 US) ten business days.
2. Secondary School Course-by-Course ($130.00 US) ten business days.
3. Associate Degree Course-by-Course ($150.00 US) ten business days.
4. Bachelor Course-by-Course: ($180.00 US) fifteen business days.
5. Master and Medical Degrees, Course-by-Course: ($205.00 US) twenty business days.
6. Ph. D. Degrees, Course-by-Course: ($285.00 US) twenty business days.
7. Comprehensive Evaluation: ($325.00 US) twenty business days.
8. Education+Work Experience ($350.00-$1,500.00 US) thirty business days.
9. Duplicates: $20.00 each if ordered with the original evaluation report; $35.00 if ordered separately. Number of copies _____ .
10. Rush Fees: $300 ONE Day ; $150 THREE Day s; $100 FIVE Days .
(Rush fees are in addition to the evaluation fees.)

IUL will also officially translate, certify, and notarize your documents for a fee of $75.00 per document × ____ documents.
IUL will issue a frameable (8.5” x 11”) short evaluation certificate for $45.00 .

I am enclosing $_____________________.

Affirmations:
I hereby affirm that a) the information provided by me is correct; b) I agree to the terms herein stated;
c) I understand this report is advisory and is not binding on anyone who uses it; d) I release International University Line for any liability for damages resulting from the use to which I, or any agency or institution, puts the evaluation report.
_________________________________________________________________________
(Signature-Applicant or Legal Representative) (Name, Printed) (Date)

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Institution	Country, Location	Dates	Name of the Diploma	Graduation Date