International Credential Assessment Service of Canada Service canadien d'évaluation de documents scolaires internationaux

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Rev. 11 01 International Credential Assessment Service of Canada Service canadien d'évaluation de documents scolaires internationaux Current Accurate Dependable ICAS provides the following assessment reports: 1. General Report Request for Assessment of Educational Documents This report describes all credentials submitted and the schools / institutions attended and for each, gives the equivalent Ontario / Canadian level of education. 2. Secondary School Comprehensive Report The Secondary School Comprehensive Report describes the education completed outside Canada at a level comparable to the secondary school level in Ontario and suggests the Ontario equivalency. This report also provides a list of all courses/subjects completed at a level comparable to the grade 11 and grade 12 levels in Ontario with the equivalent credit values and grades. 3. Postsecondary Comprehensive Report The Postsecondary Comprehensive Report describes the postsecondary education completed outside Canada, suggests the Ontario equivalency for each credential and provides a list of all postsecondary courses/subjects completed with both the equivalent credit value and grade Fee Schedule Reports General Report $ 90.00 Secondary School Comprehensive Report $120.00 Postsecondary Comprehensive Report $200.00 Secondary and Postsecondary Comprehensive $270.00 Other Services Send by fax add $ 12.00 Send by courier: within Canada add $ 25.00 to the USA add $ 35.00 to other countries add $ 85.00 Each extra original report add $ 20.00 Reports in English and French (Available if all documents are in both languages) General add $ 60.00 Secondary School Comprehensive add $ 90.00 Postsecondary Comprehensive add $ 90.00 Reports for Canada and the USA add $ 50.00 Rush Service: 1 day (24 hours) add $175.00 3 days add $ 90.00 (please call to confirm availability of rush service) Administrative Cancellation of application * $ 40.00 * if a formal request to cancel is received within three days of application Appeal of assessment $200.00 Refund if appeal is successful $200.00

Procedures Before submitting your application for preparation of an ICAS Assessment Report, please read the following information and the information which appears on the ICAS Website. 1. Review ICAS' documentation requirements and the specific requirements for each country. Original educational documents (plus a full set of clear, legible photocopies) or appropriately certified copies are required for all qualifications. In some cases, documents issued directly to ICAS are required or special procedures apply. (See country specific information for details). ICAS requires both the graduation diploma / degree certificate and all supporting documents such as record of study / transcript / indeks / diploma supplement / mark sheets for all years of study. If a thesis or dissertation was completed for a postgraduate qualification, ICAS requires a copy of the Abstract of the thesis or dissertation. If the documents were not originally issued in English or French, ICAS also requires an accurate word-for-word translation of each document. If the name which appears on the application form is different from the name which appears on the documents, an official change of name document is required (and translation if applicable). 2. Complete the application, document submission and payment forms. By completing these forms, you are confirming that you have read and accept the procedures for submission of documents and the terms and conditions including the ICAS Privacy Policy. 3. Submit the application form, document submission form, payment form and educational documents by mail, courier or in-person to ICAS' office in Guelph. Payment may be made in the form of a certified cheque, money order, bank draft in Canadian funds, payable to ICAS of Canada, VISA or MasterCard. Fees payable are non-refundable and are subject to change. ICAS of Canada, Ontario AgriCentre, 100 Stone Road West, Suite 102, Guelph ON N1G 5L3 CANADA ICAS Assessment Reports are usually sent no more than 15-20 working days after ICAS receives all the necessary documents. During peak periods, however, additional processing time may be required. Personal information collected is used only for preparing your ICAS Assessment Report. No information is released to a third party without your written consent. Your application and the supporting documents are retained for two years. An electronic copy of your assessment report is retained indefinitely. Complete information about ICAS Privacy Policy and Terms and Conditions can be found on the ICAS website at www.icascanada.ca For assistance or further information, please call (519) 763-7282 or (toll free in Canada) 1 800 321-6021. We can also be reached by e-mail at info@icascanada.ca and by fax at (519) 763-6964. For more information, you may visit our Internet site at http://www.icascanada.ca

Last/Family Name APPLICATION FORM Please read the application procedures carefully before completing this form Given Name(s) Previous Name(s) (circle) Male Female Birth Date year month day Mailing Address street and number apartment number city province / state country postal code Telephone (day) ( ) (evening) ( ) Fax ( ) e-mail Report is required for: Employment College University Secondary School Immigration to Canada (circle all that apply) US Visa Study Abroad Other (specify): Type of Assessment Required: General Report Secondary School Comprehensive Report (circle only one type of report) Postsecondary Comprehensive Report Secondary & Postsecondary Comprehensive Report Other Services: 1-Day Rush 3-Day Rush Extra Originals (specify number required) (additional fees apply) Send by Fax Send by Courier Reports in English and French Reports for Canada and the USA If original report is to be sent to a third party, give full name, address and fax number (if applicable). List all the schools/institutions you attended from primary/elementary school to the school/institution in which you are currently enrolled or which you last attended. Use the language and terminology that appear on the document(s) you received. Do not translate the names of your documents into Canadian terminology. YOU MUST COMPLETE THE ENTIRE CHART, but submit only the documents you wish to have assessed. If you require more space, please attach a separate page with this information. Dates of Attendance (year/month) Primary/Elementary Secondary Postsecondary Other School Name and Address Diploma/Degree Awarded or Highest Level Completed I,, am the above applicant (print name) I declare that the information provided on my application for preparation of an ICAS Assessment Report is true and accurate. I have read, and understand, the procedures for submission of documents I have read, and agree to, ICAS Terms and Conditions including the ICAS Privacy Policy Signed: Date Where did you hear about ICAS? Name of Institution/Organization Rev. 11 01

Please turn over and complete the Document Submission Form

DOCUMENT SUBMISSION FORM Name I understand that it is my responsibility to obtain and provide the documents required for preparation of my ICAS Assessment Report. Please note that, at any time during the process, ICAS reserves the right to request the original documents or documents forwarded directly to ICAS by the institution or to contact the issuing body for information. Enclosed are the following educational documents (please be specific and list all documents that you are submitting): 1. ~ Original (+ photocopy) ~ Certified Copy 2. ~ Original (+ photocopy) ~ Certified Copy 3. ~ Original (+ photocopy) ~ Certified Copy 4. ~ Original (+ photocopy) ~ Certified Copy 5. ~ Original (+ photocopy) ~ Certified Copy If additional space is required, please use attached sheet. I have requested the following documents to be sent directly to ICAS by the institution or appropriate authority: 1. 2. 3. If additional space is required, please attached a separate sheet. I,, am the above applicant (print name) I declare that the information provided on my application for preparation of an ICAS Assessment Report is true and accurate. I have read, and understand, the procedures for submission of documents I have read, and agree to, ICAS' Terms and Conditions including the ICAS Privacy Policy Signed: Date: Rev. 11 01

INFORMATION FOR PAYMENT Payment may be made in the form of certified cheque, money order or international bank draft in Canadian funds payable to ICAS of Canada. Payment can also be made by either MasterCard or VISA. From outside North America, payment can be made with any card, affiliated with MasterCard or VISA, which has a number beginning with U4U or U5U. Please complete the following and forward it with your application form. Services Requested Fee Assessment Report: General ($90) Secondary School Comprehensive ($120) Postsecondary Comprehensive ($200) Secondary and Postsecondary Comprehensive ($270) Other Services: 3 Day Rush ($90) 1 Day Rush ($175) Transmit by Fax ($12) Send by Courier Within Canada ($25); to USA ($35); other countries ($85) Reports in English and French (Available if all documents are in both languages) General ($60) Secondary School Comprehensive ($90) Postsecondary Comprehensive ($90) Reports for Canada and the U S A ($50) Extra Originals ($20) TOTAL FEES Payment to be made by: Money order Bank Draft Certified Cheque VISA MasterCard Credit Card Number Expiry Date (mm/yy) / Cardholder s Name as it Appears on Card (please print) Address Telephone Cardholder's Signature Rev. 11 01

TO WHOM IT MAY CONCERN Request for Evaluation of Educational Documents This is to confirm that I have authorized the International Credential Assessment Service of Canada to discuss my request and the result of the evaluation with the following: Staff Name Name of Organization/Institution; Address; Telephone Number Signed Name in Full (Please print) Date Please note that a separate form is required for each applicant.