Document Request Form Students must complete this form with applicable fees in order to request documents and student IDs. Please enable JavaScript in your browser to complete this form.Student Name *FirstLastEmail *EmailConfirm EmailPhone *Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Which School Location? *POLY Languages at IrvinePOLY Languages at Los AngelesIf you have attended more than one center, you must complete this form separately, one per center.Please select the documents you need.All the fees below are NOT refundable.CertificateCertificate of Achievement/Completion ($20)Certificate of Achievement is awarded to those who have successfully completed (C or better) the courses: RW 601, RW 602, LS 601 and LS 602. This certificate serves as our testament that the student has demonstrated proficiency in all four skills of the English language: Speaking, Listening, Reading, and Writing. Certificate of Completion is given to those who have successfully completed (C or better) at least one course from a listening/speaking series and a reading/writing series. The certificate will indicate the highest levels successfully completed from the listening/speaking series and the reading/writing series.Enrollment Verif.Enrollment Verification ($20)Enrollment Verification certifies the period that a student has enrolled. For a continuing student, the form may also indicates the projected period of enrollment for the student. For ex-students who have completed their program more than 10 year ago and the school has no record of the students, the school will only provide a letter testifying that we do not have the record and it is not fault of the student.TranscriptOfficial Transcript ($25)An official transcript is a complete representation of a student’s attendance and academic record. It includes all courses attempted at POLY Languages Institute, including those withdrawn from and those repeated. For ex-students who have completed their program more than 10 year ago and the school has no record of the students, the school will only provide a letter testifying that we do not have the record and it is not fault of the student.Student IDStudent ID ($20)Student ID Photo Requirement To process your Student ID, you must upload a recent photo that meets the following guidelines: – Taken against a plain, light-colored background (white or off-white preferred) – Full-face view, directly facing the camera – No filters or heavy editing – No hats, sunglasses, or accessories that obscure the face (except for religious or medical reasons) – Good lighting with no shadows on the face or background Photos that do not meet these standards may be rejected. Student ID.Your Photo * Click or drag a file to this area to upload. Acceptable file extensions are jpg, jpeg, jfif, tiff, tif, gif, and png. The file size must be less than 12 megabytes. Processing Option *Standard Processing (No Fee) – The processing time is 10 to 20 days for all documents. For Student ID requests, allow an additional 10 days for delivery to the center.Rush Service ($25 Fee) – The processing time is within 10 days for all documents except Student IDs. For Student ID requests, allow an additional 10 days for delivery to the center.Delivery Method *Mail – Outside the U.S. ($80)Mail – Within the U.S. ($40)Pick Up In Person (Free)We use courier services with tracking to ensure safe delivery. You may also choose to pick up your documents in person at your affiliated center at no cost.Mailing Address – International *Address Line 1Address Line 2CityState / Province / RegionPostal Code– Select One –AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryMailing Address – US *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeMessageTotal Due:$0.00Assisted by (Optional)State the name of the advisor who assisted you in completing this form.Stripe Credit Card *CardName on CardAcknowledgement and Agreement *I understand and agree that the service fees indicated herein are not refundable. Furthermore, if I have selected the Pickup-in-Person for the delivery method, I agree to pick the requested documents within 90 days from the date this form is submitted. Otherwise, I understand that the requested documents will be discarded without any refund.PhoneSubmit