Rio Salado College Adult Education ACEI Application Form

Applications received on or after 3pm Pacific Standard Time, or submitted on a weekend or any holiday, will be processed the following business day.
SECTION A. PERSONAL INFORMATION
A1. Full Name
First Name*
Middle Name
Last Name*
A2. Email*
example@example.com
A3. Birth Date*

MonthDayYear
A4. Country of Birth:*
Yes
If YES, Please provide your ACEI REFERENCE #
If YES, Please provide Date for when you initially applied to ACEI
No, I have not applied previously to ACEI
FURTHER EDUCATIONEMPLOYMENT
OTHER: (please specify)
SECTION B. ACADEMIC HISTORY
B1. HIGH SCHOOL/SECONDARY SCHOOL
Name of Institution*
City*
Country*
Secondary/High School Start Date*
Secondary/High School End Date*
Name of Credential Earned*
B2. UNIVERSITY/COLLEGE LEVEL EDUCATION (1) (Enter "NONE" if not applicable)
Name of Institution*
City*
Country*
University/College Start Date*
University/College End Date*
Name of Credential Earned (Certificate/Diploma/Degree)*
B3. UNIVERSITY/COLLEGE LEVEL EDUCATION (2) (Enter "NONE" if not applicable)
Name of Institution
City
Country
University/College Start Date
University/College End Date
Name of Credential Earned (Certificate/Diploma/Degree)
SECTION C. DOCUMENT UPLOAD
Upload high-quality color PDF scans of both sides of the official original certificate(s), diploma(s) or degree(s) with transcripts/mark sheets (courses and grades), certified English translations (if applicable), and proof of name change (if applicable). DO NOT USE YOUR PHONE OR ANY APP TO SUBMIT IMAGES/PICTURES CONVERTED TO A PDF FILE.
UPLOAD CREDENTIALS/DOCUMENTS (pdf. only) For Initial Review.

UPLOAD

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SECTION D. TYPES OF EVALUATION REPORTS & ADDITIONAL SERVICES
D1. Evaluation Report Type (SELECT ONE)
High School Basic Report - $ 115.00High School Comprehensive Report - $175.00College/University Basic Report (Single Credential) - 115.00College/University Basic Report (Multiple Credentials-More than one document/credential) (Navigator Approval Required)- $165.00College/University Comprehensive Report (Single Credential-Studies leading to a first degree/credential) - $205.00
D2. ADDITIONAL College/University Credentials (COMPREHENSIVE Report) - $105.00 per Credential (Navigator Approval Required)

IMPORTANT: You must first select D1. College/University Comprehensive Report (Single Credential) – $205 before adding additional credential fees.
Select number of additional credentials (Select "NONE" if not applicable)*
D3. DELIVERY of Official Evaluation Report

(ACEI is a paperless service. All official evaluation reports are issued digitally.)
Unofficial Evaluation Copy to Rio Salado College Adult School- Fee Waived
Email Delivery (Official Evaluation Report to Third Party) - $15.00Hold Official Evaluation Report - $15.00
ACEI releases official evaluations digitally to third parties only. If you do not have a recipient at this time, ACEI will hold your official evaluation for future release.
Third-Party Recipient Information:

(Enter N/A in each field if you do not have a recipient at this time)
INSTITUTION NAME *
CONTACT NAME *
DEPARTMENT *
PHONE NUMBER *
EMAIL Address*
SECTION E. CONTRACT FOR SERVICE
Declarations and Authorization for Services by Applicant

By submitting my application and documents to Academic Credentials Evaluation Institute, Inc. (ACEI), I hereby declare and acknowledge the following:
1. I understand that the ACEI application constitutes a contract for services, and I have read and agree to the Terms & Conditions. All documents submitted are authentic, original, and unaltered records issued by the appropriate institution or authority.
2. I understand that ACEI may verify documents with issuing institutions or authorities at any time and may request official records directly from the source.
3. I understand that submission of fraudulent or altered documents will result in cancellation of the evaluation, forfeiture of fees, notification to relevant parties, and reporting to authorities.
4. I understand that evaluations based on uploaded documents may not be accepted by institutions that require official records to be sent directly.
5. I confirm that all information provided in my application is true, accurate, and complete to the best of my knowledge and accept full responsibility for the documents submitted.
6. I certify that this request is made under Rio Salado College’s Adult Education program and authorize ACEI to invoice Rio Salado College as the responsible paying party for this evaluation.
By signing below, I affirm that I have read, understood, and agree to the above declarations and ACEI Terms & Conditions.
First and Last Name & Signature*

First NameLast Name
Signature*
Date
Comments
Invoice Due Upon Receipt
Should be Empty:

Applications received on or after 3pm Pacific Standard Time, or submitted on a weekend or any holiday, will be processed the following business day.

SECTION A. PERSONAL INFORMATION

SECTION B. ACADEMIC HISTORY

SECTION C. DOCUMENT UPLOAD

SECTION D. TYPES OF EVALUATION REPORTS & ADDITIONAL SERVICES

SECTION E. CONTRACT FOR SERVICE