Ced Application Form

PO Box 231126
Boston, MA 02123
Tel. 617.338.7171
Fax. 617.338.7101
www.cedevaluations.com
Center for Educational Documentation
1. PERSONAL INFORMATION
Family / Last
Name
First Name
Middle
Initial
Other names that

appear on records
Mailing Address
Street No. and Name
Apt. No.
City
State
Email
ZIP / Postal
Code
Phone
Date of Birth
(MM/DD/YYYY)
Has CED prepared an

evaluation for you before?
When ordering more than one type of basic service,

the highest fee will apply.
Please choose below the type(s) of evaluation needed in part A, AND indicate the
purpose(s) of the evaluation in part B. For CPA only part A is needed.
Regular service is 15 business days.
IF ORDERING A RUSH SERVICE, TOTAL FEE MUST BE MONEY ORDER ONLY
General Evaluation ($75)
YES
If YES, when was the

last one done?(Year)
ADDITIONAL SERVICES
With evaluations previously done by CED
Retyping ($25)
Additional Document ($50)
Change to CPA Evaluation ($110)
SPECIAL SERVICES
Additional Reports ($10 each)
Fees additional to Basic Service

Please CALL BEFORE requesting 1-2 day service
Rush Service (1-2 working days) ($150) (TOTAL payment by Money Order only)
Course-by-Course Evaluation ($125)
Rush Service (5-10 working days) ($50) (TOTAL payment by Money Order only)
CPA Examination & Licensure ($150)
NO
Please enclose appropriate fees with the application. Fees are non-refundable.
Checks should be made payable to: Center for Educational Documentation
2. FEES AND SERVICES
Sex
U.S. Social Security

Number (if any)
Country of your
Credentials
BASIC SERVICES
Country
Interpretation (French, Portuguese and Spanish only) ($50)
Freshman Admission
Visa
Graduate Admission
Employment
Transfer Credit
Teacher Certification
MAILING OPTIONS
State:_______
Name of contact
person/Department
Certified Mail up to 16 ounces (Only within USA) ($5)

Registered Mail (International) ($15)
Additional reports, if ordered at the same time ($10 each)
3. MAILING INSTRUCTIONS
The original of the evaluation will be sent to the person/institution indicated below. A copy will be sent
to you. If more reports are requested, please include names and addresses on the back of this form.
Institution
Address
Phone
State
City
4. CREDENTIALS
(Return of Original Documents)
ZIP / Postal
Code
The following credentials should be submitted for the evaluation:
a) All of your diplomas, degrees, titles and certificates:

b) Transcripts or annual course and grade listings for all years of college-level study, study books or statement of marks;
c) Program outlines or course description as needed;
Clear, notarized copies showing the stamps or the seal of the institution you attended should be submitted. Original documents may be requested.
Word by word, line by line translation of all records not in English must accompany the above records. CED may request licensed translation ser-
5. EDUCATIONAL CHRONOLOGY
Year of Entry
1.
2.
3.
4.
5.
6.
7.
V. 12/29/2005
Institution
List all institutions attended, starting with primary

school (Grade 1) and give dates. List all study, but
submit only high school and/or college documents.
Graduation Year
Name of Diploma, Degree in English

and Original Language
If there are gaps in attendance or if certain

records are unavailable, please explain on the
back of the application.
If an applicant submits forged, altered or
falsified documents, no evaluation report will
be prepared and no refund will be made. All
documents will be retained by CED and other
evaluations agencies will be notified.
I understand that this evaluation is advisory
in nature and is not binding on any agency or
institution that uses it. I will not hold the Center for Educational Documentation or any of its
employees responsible for any disagreements
arising from the same.
I have read all the information provided by
CED and I accept the terms and conditions.
Signature and Date
6.
Form not valid without proper signature. Please enclose payment with application. All fees subject to change without prior notice.

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PO Box 231126

Center for Educational Documentation

Other names that

Has CED prepared an

When ordering more than one type of basic service,

If YES, when was the

With evaluations previously done by CED

Additional Document ($50)

Change to CPA Evaluation ($110)

Additional Reports ($10 each)

Fees additional to Basic Service

CPA Examination & Licensure ($150)

2. FEES AND SERVICES

U.S. Social Security

Interpretation (French, Portuguese and Spanish only) ($50)

Certified Mail up to 16 ounces (Only within USA) ($5)

Additional reports, if ordered at the same time ($10 each)

(Return of Original Documents)

The following credentials should be submitted for the evaluation:

a) All of your diplomas, degrees, titles and certificates:

List all institutions attended, starting with primary

Name of Diploma, Degree in English

If there are gaps in attendance or if certain

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