Academic Records Request Form - World Education Services
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1
2Academic Records Request Form
For
Applicants:
A.
This form is provided to facilitate the release of your academic records by your academic
institution.
You are responsible for contacting your academic institution directly.
1)
Complete the top part of this form. You must include your WES reference number.
2)
Submit this form to the registrar/controller of examinations or other authorized official where you obtained your credential(s).
3)
Print additional copies of this form as necessary.
WES Reference No. (required)
Last/Family Name
First/Given Name
Previous Name (if applicable)
Date of Birth (dd/mm/yyyy)
E-mail
Institution Name
Country
Dates Attended
From_____________________ To ____________________
(mm/yyyy)
(mm/yyyy)
Degree Name (if applicable)
Year of Award (if applicable)
Major
Student ID or Roll Number at sending institution (if applicable)
I hereby authorize the release of my academic records to World Education Services.
Applicant’s signature: _____________________________________________________
Date: _____________________
For Authorized
Officials:
B.
The person named above requests that their academic records be released to World Education
Services. His or her records/statement of marks should show all subjects completed and all grades/marks awarded for all years of
study.
1) Please complete this form.
2) Place this form and academic record(s) in an envelope.
3) Sign and seal the envelope across the back flap.
Institution Name:
Degree obtained: (if applicable)
Date awarded: (month/yr)
Name of Official Completing Form: (please print or type)
Title:
Telephone:
Email:
Authorized signature and seal: _________________________________________________
Date: ________________________
Yes. The applicant’s academic records are attached to this form.
Please send this form and academic records directly to WES at the address below:
WES Reference No.____________________
World Education Services
Attention: Documentation Center
2 Carlton Street, Suite 1400
Toronto, ON M5B 1J3
Canada
3/2015
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