Request For "Teacher Evaluation" Letter Form

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Request for a “Teacher
OFFICE OF THE REGISTRAR
Waterloo, Ontario, Canada N2L 3G1
Evaluation” Letter
519-888-4567, ext. 33164 | fax 519-746-2882 | uwaterloo.ca/registrar/
Please include the $25.00 processing fee and any applicable courier costs. This processing fee entitles you to two copies of the letter. Add
additional courier costs if applicable.

Request for Qualifications Evaluation Council of Ontario (QECO)
Request for Alberta Teachers’ Association (ATA)
Other (specify) ___________________________________________________________________________________________
Select distribution:
Select method of mailing:

Send two copies of the letter to me.

Send the letter to QECO, ATA, or Other by regular mail.

Send one copy of the letter to  QECO  ATA  Other

Send the letter to QECO, ATA, or Other by courier (add
applicable courier costs).
Indicate the address where the letter is to be sent.
Street address __________________________________________________________________________________________________
City _________________________ Province/State _______________ Postal/Zip code _____________ Country ____________________
Student information
Waterloo student identification number __________________________________________
Last name _____________________________________________________________________________________________________
First name _______________________________________________ Middle name(s) _________________________________________
Street address __________________________________________________________________________________________________
City _________________________ Province/State _______________ Postal/Zip code _____________ Country ____________________
Telephone (area code) __________ (number) ________________________ Email address _____________________________________
Complete the following information
As per instructions on the attached document, I am requesting the University of Waterloo to provide a letter to do the following.
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
Student signature _________________________________________________ Date __________________________________________
Note:
This request will be processed as soon as possible after receiving:
o
all supporting documents
o
processing fee
o
any applicable courier costs: $10.00 per letter fee (Ontario); $20.00 per letter fee (Canadian locations outside of Ontario);
$25.00 per letter fee (United States); $35.00 per letter fee (outside of Canada and the United States)
o
copies of transcripts from other post-secondary institutions (if you received transfer credits from the University of Waterloo)
o
a paper copy of your Teacher Evaluation request letter
o
your selection for distribution and method of mailing completed at the top of this form
Credit card information
Credit card number ______________________________________________________ Expiry date (MM) __________ (YY) ___________
Name on credit card __________________________________________ Cardholder signature __________________________________
For office use only
Cash
Cheque
Debit
Money order
Credit card
WatCard
Other ____________________________________
Amount $ __________________ Received by _______________________________ Date Received _____________________________
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