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Academic Credentials
Evaluation Institute, Inc.
For
A C E I u s e o n l y
9461 Charleville Boulevard,Box 188
Beverly Hills, CA 90212, USA
DATE:
REF#
Phone: 310.275.3530
Fax: 310.275.3528
BR
CR
CMR
24-R
3-R
5-R
Website: www.acei1.com
E-mail: acei@acei1.com
FEES: $
A P P L I C A T I O N F O R E V A L U A T I O N O F F O R E I G N E D U C A T I O N A L C R E D E N T I A L S
Before completing this form, make sure that you have read ALL information provided in http://www.acei1.com/academicevaluation.html
Please PRINT or Type Clearly
NOTE: Failure to provide complete information will delay the application process.
SECTION A. PERSONAL INFORMATION
A1. Name: ______________________________________________________________________________________
Lee
Namu
v
Male
Female
(Last/Family Name)
(First Name)
(Middle Name)
A2. Mailing Address: _____________________________________________________________________________________________________
(Number & Street)
(Apt./Flat/Suite#)
(City)
(State)
(Zip/Postal Code)
(Country)
34, Jong-ro,
Jongno-gu
Seoul
110-110
Korea
A3. Telephone: (___) _____________________
(___) __________________________
822 736-2500
822 736-2500
namuedu@namucpa.com
Day time/Evening
Fax#
E-mail
A4. Birth Date: ________________________________________________
Country of Birth: _________________________________________
4
1
1985
Korea(ROK)
(Month)
(Day)
(Year)
A5. Have you ever applied to ACEI:
NO
YES - If yes, when? (date)
v
ACEI Ref. #:
A6. Who referred you to ACEI? _____________________________________________________________________________________________
namu
SECTION B. ACADEMIC HISTORY
List ALL educational institutions attended and now attending, beginning with primary school (if additional space is needed, please use a
separate sheet of paper and attach to this form). This section must be completed.
Name of Institution(s)
City/Country
Dates of Attendance
Credential(s) Earned
From/To
AB Elementary SchoolSeoul03.1992-02.1998Graduated
CD Junior High SchoolSeoul03.1998-02.2001Graduated
EF High SchoolSeoul03.2001-02.2004Graduated
GH UniversitySeoul03.2004-02.2012학위명
SECTION C.PRIMARY PURPOSE FOR EVALUATION
Please check ( ):
Further Education - Please specify name of institution: __________________________________________
Employment
Immigration
Other ________________________________________
Professional Licensure - State:Profession: ______________________________
v
CA
SECTION D. EVALUATION MAILING
Please check ( ):
□ Mail OFFICIAL evaluation and DUPLICATE (unofficial) COPY directly to the address in A2 above.
□ Mail OFFICIAL evaluation to the address(es) shown below and the DUPLICATE (unofficial)
COPY to the address in Section A2 above. (If you list more than one address below, see Section
E2.for extra charges.) (NOTE: there is a required mail fee for each mailing address, see section E4.)
Attach an additional sheet if needed.
1. Name: _________________________________________
Title/Company/Institution: ____________________________
Address: __________________________________________
Telephone: (___) _________________________________
E-mail: ____________________________________________
Vermont Board of Public Accountancy
150.00
Office Of Professional Regulation National
Life Bldg., North, FL 2 Montpelier, VT 05620-3402
802 828-2808
peter.comart@sec.state.vt.us
Select Type of Mailing
□ 1st Class □ Priority
□ Air Mail □ Courier/Express
□ 1st Class □ Priority
□ Air Mail □ Courier/Express
□ E-mail
2. Name:
Title/Company/Institution: ______________________
Address: ____________________________________
Telephone: (____) ___________________________
E-mail: _____________________________________
NOTE: If you are requesting Express/Overnight/Courier Mail Delivery, please provide a street address and phone#.(No P.O. Boxes)
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SECTION E. TYPES OF EVALUATION REPORTS & ADDITIONAL SERVICES
E1. Evaluation Report:
Please Check ( ) to indicate selection of report:
Enter Amount
BASIC REPORT (suitable for employment/immigration/military enlistment)
□ High School/Secondary Level Education (only)
$100.00
$ ________________
□ College/University Education:
□ Fee for studies leading to 1st degree/credential
$100.00
$ ________________
□ Fee for each additional degree/credential
(specify # of credentials) ________ x
$ 30.00
$ ________________
COURS REPORT (suitable ONLY for California Board of Accountancy)
□ College/University Education:
□ Fee for studies leading to 1st degree/credential
$150.00
$ ________________
v
v
150
□ Fee for each additional degree/credential
(specify # of credentials) ________ x
$ 50.00
$ ________________
COMPREHENSIVE REPORT [Course-by-Course with Grades & Course Levels]
(suitable for further education/continuation of studies, teacher Certification, professional certification)
□ High School/Secondary Level Education (only)
$180.00
$ ________________
□ College/University Education:
□ Fee for studies leading 1st degree/credential
$180.00
$ ________________
□ Fee for each additional degree/credential
(specify # of credentials) ________ x
$ 90.00
$ ________________
□ Course Match (only if requested by U.S. College or University - additional fee
)
$100.00
$ ________________
E2. EXTRA OFFICIAL REPORT (optional)
(specify # of extra reports) ________ x
$ 30.00
$ ________________
E3. RUSH SERVICE (optional, check only one)
Payments for RUSH Service evaluations must be submitted by money order/cashier’s check/credit card.
□ One (1) Business Day
(Completed with in 1 full business day from receipt of documents)
$250.00
$ ________________
□ Three (3) Business Day (Completed with in 3 full business day from receipt of documents)
$200.00
$ ________________
□ Five (5) Business Day
(Completed with in 5 full business day from receipt of documents)
$150.00
$ ________________
E4. MAILING/SHIPPING/HANDLING DELIVERY (REQUIRED)
Evaluation fee does NOT include the cost for mailing. Select a mailing option for each mailing address provided. If required mailing fee is not
selected, you will be charged the First Class mailing fee of $ 7 for each mailing address provided or Air Mail fee of $12 for overseas/international
address(es).
□ Air Mail
(specify # of mailings)
___ x
$ 12.00 min.*
$ ________________
(overseas/international - no tracking for package or gaurantees delivery)
v
12.00
□ Priority Mail
(specify # of mailings)
___ x
$ 14.00 min.*
$ ________________
v
14.00
(domestic/US only - provides you tracking and gaurantee delivery 1-3 business days)**
□ Courier/Express
(specify # of mailings)
___ x
$ 40.00 min.*
$ ________________
(domestic/US only - provides tracking and gaurantees next day delivery)
□ Courier/Express
(specify # of mailings)
___ x
$ 80.00 min.*
$ ________________
(overseas/international - provides tracking and gaurantees next day delivery)**
□ E-mail (OFFICIAL evaluation, only to 3rd party)
(specify # of mailings)
___ x
$ 10.00
$ ________________
□ FAX (OFFICIAL evaluation, only to 3rd party)
(specify # of mailings)
___ x
$ 10.00
$ ________________
* Mailing and delivery fees listed are the minimum fees for each type of mailing. Certain delivery locations/oversized/extra - large original
documents will require additional fees for return mail. Applicants will be notified of the additional postage fee once documents and
application are on file.
** Delivery time may vary depending on deliver location/region.
TOTAL FEES
$ ________________
176.00
E5. PAYMENT (REQUIRED)
Select Method of Payment:
(Make payments payable to: ACEI)
□ Personal Check
□ Cashier’s Check
□ Money Order
□ Debit Card (Visa/MasterCard)
□ American Express
□ Discover
□ MasterCard
□ Visa
v
For Credit Card Payments, please complete the following:
Card Number: _________________________________________________________________________________ Expiration Date: ______ / ______
0000-0000-0000-0000
11
2011
Month
Year
3-digit code/CVVS [see back of card] Visa/MasterCard/Discover: _______
4-digit code [see front of card] American Express: _______
123
4567
Billing Address of Credit Card: ___________________________________________________________________________________________________
Jongno-gu
Seoul
110-110
Korea
Street / P.O. Box
Apt./Suite#
State
Zip Code
Country
Card Holder’s Name (please print): ________________________________________________________________________________________________
(First/Given Name)
(Middle Name)
(Last/Family Name)
Namu
EDU
I hereby authorize the Academic Credentials Evaluation Institute, Inc. (ACEI) to utilize my credit/debit card for the detailed billing as noted on the
ACEI Application for Evaluation of Foreign Educational Credentials.
Signature:__________________________
Date:__________________________
2
SECTION F. TERMS & CONDITIONS
1.
Altered orForgedAcademic Credentials
An evaluation will not be prepared and fees will not be refunded in the event ACEI determines, in its sole but reasonable discretion, that the educational credentials submitted for
evaluation have in any way been altered, tampered, modified or forged, whether by the applicant or any other third party (collectively, “Forged Credentials”). All documents
(photocopies/originals/official) provided become the property of AC EI. The institution, agency, or professional licensing board for which the evaluation is intended, U.S.government
agencies, and other evaluation services will be notified in the vent ACEI believes the credentials submitted for evaluation are Forged Credentials.
2.
Equivalency Recommendations & Guarantees
The U.S. educational equivalencies recommended in ACEI evaluation reports are in accordance with established guidelines and represent the considered judgments of qualified
evaluators. Applicant acknowledged having been informed that ACEI evaluation reports are advisory only and that ACEI’s recommended U.S. educational equivalencies may differ
or otherwise vary from advisories rendered or prepared by other third party academic evaluators or source institutions. ACEI evaluations and/or recommendations are not binding
on any institution, agency or third party. Additionally, applicant acknowledges having been informed and agrees that (1) although ACEI shall use reasonable efforts to determine the
validity of such information it receives, ACEI does not and cannot guarantee against ubmitting its report or evaluation and/or recommendations based on review of Forged
Credentials or other fraudulently altered items (whether the same has been sent directly to ACEI by the source institution or directly by the Applicant) and (2) ACEI shall have no
liability, duty, or obligation to applicant, Applicant Parties (defined below under Terms and Conditions Section 12) or any source institution in the event ACEI submits a report or
evaluation based on its review of any information or record that is ultimately deemed to be a Forged Credential despite ACEI’s reasonable determination that the same was not
Forged Credential at the time of initial submission or review. Without limiting any of the foregoing, ACEI does not guarantee that an applicant, agency, or any third party will agree
with its educational equivalency recommendations and assumes no responsibility for judgments or opinions made by an applicant, agency, or by any third party which disagrees
with its educational equivalency recommendations. In the event or any disputes between the applicant and ACEI, such disputes shall resolved by Mediation (as more particularly
described below under Terms and Conditions Section 12) and governed by California law and shall be subject to exclusive the jurisdiction of the Los Angeles County Courts without t
reference to.
3.
Evaluation Results
ACEI will not release the results of an evaluation on the telephone, email, or by facsimile (FAX) to the applicant. As indicated in Section 5 (Instructions), the fee for the evaluation
covers one official report and one duplicate unofficial copy. If you do not authorize the release of the official report to an institution, agency or third party, ACEI will send you the
official report in a sealed envelope which should be opened by the institution, agency or third party for which the evaluation is intended.
4.
Evaluation Review
After the evaluation has been completed, any questions regarding the evaluation report, based on the documents provided to ACEI with the initial application, must be submitted in
writing to ACEI within the first two (2) months of the completion date (“Grace Period”). Requests for review of the evaluation or questions concerning the evaluation submitted after
expiration of the "Grace Period" shall be subject to a $50.00 review fee.
5.
Re-Activation
If an applicant fails to provide all required documentation with the application within two (2) months of the date the application was received, Applicant acknowledges and agrees
that the application shall automatically be deemed as inactive. A $50.00 re-activation fee is required to process an inactivate file.
6.
Re-Evaluations
Re-evaluations of credentials not submitted with the original application request are treated as new evaluations and full payment with a new application for the evaluation report is
required. Requests to change a Report type (e.g. Basic Report to a Comprehensive Report or vice-versa), once an evaluation has been completed, requires the full evaluation fee
for the new type of Report.
7.
Refunds
Do not submit an application with insufficient documentation, as fees are non-refundable once an application for credential evaluation has been submitted to ACEI. A refund will be
made only when an applicant has paid to ACEI more than the required cost of the evaluation. No refund will be issued when application is cancelled. (See Terms and Conditions
#Section11)
8.
Insufficient Documentation
ACEI will contact the applicant or agent representing the applicant if additional information, documents, or fees are needed, as determined by ACEI. Subject to the terms and
conditions set forth under Section 5 above (Reactivation). The application will be kept in pending status until all documentation and fees have been received.
9.
Verification of Educational Credentials
ACEI, in its sole and absolute discretion, may elect to inquire about, clarify, and/or verify any and all educational documents submitted for evaluation to ACEI with the issuing
institution(s).
10.
Evaluation Expiration
The evaluation report and any documents submitted with an application are kept at the ACEI archive for a period of three (3) years from the date it was completed. Requests for
extra official reports of an evaluation that are more the three (3) years old shall be subject to a new application and submission of credentials and fees for a new evaluation.
11.
Cancellation
No refunds shall be made when an application is cancelled after the application form for evaluation has been submitted and a case file has been opened.
12.
Mediation
Applicant, on behalf of itself and its representatives, affiliates, and agents (“Applicant Parties”) hereby agree to mediate any dispute or claim arising between ACEI and Applicant
and/or Applicant Parties them out of this Agreement before resorting to any arbitration or other legal action. Mediation is a process by which parties attempt to resolve a dispute or
claim by submitting it to an impartial, neutral mediator, who is authorized to facilitate the resolution of the dispute, but who is not empowered to impose a settlement on the parties.
The parties agree to employ ADR Dispute Resolution Services in Los Angeles, California, or if an acceptable panel member from that organization is not available within 30 days of
the date of submission of this matter to mediation, then to another commercial mediator or mediation service mutually elected and mutually agreed to by Applicant and ACEI ("ADR
Services"). Mediation fees, if any, shall be divided equally among all of the parties involved and shall be paid to the mediator prior to the commencement of the mediation.
Evidence of anything said, any admission made, and any documents prepared in the course of the mediation, shall not be admissible in evidence, or subject to discovery in any
arbitration or court action, pursuant to California Evidence Code Section 1152.5. If any party commences any litigation or court action based on a dispute or claim to which this
Section 12 applies without first attempting to resolve the matter through mediation, then if such party prevails in the litigation or court action, the trial court shall have the authority to
allow such party to recover its attorneys' fees or costs of suit.
13.
Attorneys' Fees
In any mediation, litigation, or other legal proceeding which may arise between Applicant, ACEI and any third party that becomes a party to the subject matter set forth under the
application, the prevailing party shall be entitled to recover its costs, including costs and actual attorney’ fees in addition to any other relief to which such party may be entitled.
14.
Disclaimer
Applicant, on behalf of himself or herself and on behalf of Applicant Parties, acknowledges and agrees that ACEI has not and does not make any guaranty or warranty to Applicant
that it can fully safeguard against reviewing fraudulently tampered, altered, forged, or modified documents although ACEI shall use reasonable efforts to prevent doing so. No
express or implied guarantees are made by ACEI with respect to its ability to, at all times, accurately identify forged, fraudulent, tampered, or altered credentials, transcripts or other
items submitted to it for review.
15.
Release
Except for instances of the sole,and gross negligence and intentionally reckless misconduct of ACEI, the Applicant, for himself or herself and on behalf of Applicant Parties,
releases and forever discharges ACEI and its respective officers, directors, shareholders, members, managers, partners, agents, affiliates, successors, and assigns (collectively,
"ACEI Parties") from, and waives any right to proceed against ACEI or ACEI Parties for, any and all costs, fees, obligations, damages, expenses, claims, liabilities and demands
(including attorneys' fees and costs) at law or in equity, whether known or unknown, seen or unforeseen, rising out of or relating to, whether directly or indirectly, (i) this
Application; (ii) ACEI’s review of any information, credentials, transcripts or other documents whether provided by Applicant or the sourcing institution; (iii) any evaluation report or
recommendation made by ACEI; and (iv) any review, finding or recommendation made by ACEI based on its review of forged, fraudulent, tampered, altered or other forged
information it received and reviewed
Without limiting the foregoing, Applicant waives the provisions of Section 1542 of the California Civil Code, which provides: A GENERAL
RELEASE DOES NOT EXTEND TO CLAIMS WHICH THE CREDITOR DOES NOT KNOW OR SUSPECT TO EXIST IN HIS OR HER FAVOR AT THE TIME OF EXECUTING
THE RELEASE, WHICH IF KNOWN BY HIM OR HER MUST HAVE MATERIALLY AFFECTED HIS OR HER SETTLEMENT WITH THE DEBTOR.
3
Please check box:
I have read and agree to the Terms and Conditions listed in Section F.
SECTION G.CERTIFICATION BY APPLICANT / AGENT REPRESENTING APPICANT
G1. I certify that, to the best of my knowledge, all the information provided in this form is true, complete and correct.
G2. I certify that I have read Sections 1 through 5 of INSTRUCTIONS and TERMS & CONDITIONS of Academic Evaluation as posted above
and/or under Services: Academic Evaluation http://www.acei1.com/academicevaluation.htmland agree to the terms stated herein.
G3. I understand that the evaluation prepared by ACEI is advisory and not binding upon any individual, institution or agency that uses it and
release ACEI from any liability for damages resulting from the use of the evaluation report.
G4. I understand that, once this application is submitted, there are no cancellations and all fees are non-refundable.
(Name, Printed)
(Signature)
(Date)
CHECKLIST
Before submitting your application to ACEI, please answer the following questions:
□ Have you read the instructions and information on the ACEI application http://www.acei1.com/academicevaluation.html.?
□ Have you completed and signed the ACEI application?
□ Have you sent in all your educational credentials http://www.acei1.com/academicdocuments_ae.html?
□ Have you provided certified English translations of all your educational credentials?
□ Have you enclosed the applicable fee?
APPLICATION MAILING – ACEI’s Mail Processing Centers:
Los Angeles Location*
Monterey Park Location*
West Los Angeles Location*
ACEI
ACEI
ACEI
9854 National Boulevard, Box 186
333 W. Garvey Street, Box 254-B
9461 Charleville Boulevard, Box 188
Los Angeles, CA 90034
U.S.A.
Monterey Park, CA 91754
U.S.A.
Beverly Hills, CA 90212
U.S.A.
*NOTE: This mailing handling facility accepts; DHL, FedEx, UPS, etc. No walk-ins.
Thank you.
Rev. 1/1/14
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