Global Credential Evaluators, Inc.
P.O. Box 761· Cedar Park, TX 78630 · USA · 800-517-4754 · FAX 512-528-9293

RE-EVALUATIONS

Please complete this form and mail or fax to the above number with credit card payment.

Reference Number (REF:) __________________ or date of completion __________________

Indicate office which completed the evaluation _____VA ____TX ____MS ____AZ

Name on evaluation ___________________________________________________________________
                                          last or family                         first                            middle
Current address _______________________________________________________________________

                        _______________________________________________________________________

                        _______________________________________________________________________

Phone Number: ________________________

Fax Number: _________________________

E-mail address __________________________
(please print e-mail address)

Fees are subject to change without prior notice.

___ Number of Copies ($10.00 per copy)
___ Course-by-Course ($125.00)
___ Document by Document ($75.00)
___ One Business Day Rush ($200 covers overnight delivery to U.S. Addresses only)

___ Three Business Day Rush ($125 covers overnight deliver to U.S. Addresses only)

___ Priority Mail ($8.00 per address)
___ Overnight Express Mail ($20.00 per address; U.S. addresses only)
___ Return Original Educational Records ($15.00) (sent certified, you will need to sign for them, this does not refer to your evalaution)
___ International Express ($50)

Method of Payment: ___Cashier Check ___ Money Order ___

Credit Card (___ Visa ___ Master Card___ American Express)

Card Number ____________________________Expiration Date ____ Month _____ Year _____ CVC*

*CVC is the additional three-digit number found on the back of Visa or Master Card or the four-digit number on the front of American Express.

Total Amount ___________ Card Holders Signature: _______________________________________

Address(es) to be mailed if different than above:

            ______________________________         ______________________________

            ______________________________         ______________________________

            ______________________________         ______________________________
Continue on back if necessary.