APPLICATION FORM FOR ACADEMIC DEGREE AUTHENTICATION AND CERTIFICATION

APPLICATION FORM FOR ACADEMIC DEGREE AUTHENTICATION AND CERTIFICATION
Personal Information
(Please fill out to the best of your ability)
Full Name*
Email Address*
example@cubaeal.com
Phone Number*
Date of Birth*

MonthDayYear
Citizenship *
Citizenship
Upload Passport Copy*

Upload a File

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Please provide the name of the agency where you would like the original certified documents to be delivered.
Please provide the address of the agency where you would like the original certified documents to be delivered.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Educational Background
Name of Medical School*
Year of Graduation*
Degree Obtained*
Specialization (If none, type N/A)*
Upload First Academic document *

Upload a File

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Upload Second Academic document

Upload a File

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Upload Third Academic document

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Employment Details
Are you currently employed in the medical field?*
If yes, please provide details about your current employer and position (Type N/A if the answer to the above question is No)*
Are you seeking employment in a specific country or region?*
If yes, please specify (Type N/A if the answer to the above question is No)*
Additional Information
Why do you need your medical degree certified by MINREX? (Please provide a brief explanation)*
Do you have any specific deadlines or timeframes for the certification?*
If yes, please specify date

MonthDayYear

WHAT IS NEXT?
Once we receive this form, our technical team will review it. You will then receive a separate email containing the following details:
- The delivery address where you should send the original academic documents for certification.
- The total cost of certification and payment instructions.
Should be Empty: