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 *MM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Which School Location? *POLY Languages Institute at IrvinePOLY Languages Institute at Los AngelesPOLY Languages Institute at PasadenaIf 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 It includes all courses attempted at POLY Languages Institute, including those withdrawn from and those repeated.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)For a Student ID, a student's photo must be uploaded. There are several guidelines for the photo to be acceptable. The photo must be taken in front of the background approved by the administration office. Contact the administration office for assistance in taking the photo for the 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. Do you need Rush Service?Rush Service ($25)The normal processing time is 10 to 20 days. If you select Rush Service, the processing time will be within 10 days.How would you like your acceptance package delivered? *By mail outside the US ($80)By mail within the US ($40)Pickup-in-Person from the PA center ($0)For mailing packages, we use courier companies that have a tracking system to ensure their delivery. You may opt to pickup-in-person (free of charge) at the following address: 2900 East Colorado Blvd., Pasadena, CA 91107.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, Province of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited 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 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeMessageTotal Due:$ 0.00Stripe Credit Card *CardName on CardAcknowledgement and AgreementI acknowledge that I have access to the School Catalog, and I have read, understood, and I agree to all the terms and conditions of this Application for Admission and the School Catalog. Furthermore, I agree to accept full responsibility for all my expenses while attending POLY Languages Institute and for my actions while participating in excursions or any other activities. I agree to assume all risks of harm arising from such participation. In case of illness or injury, permission is granted to an appropriate medical center to undergo examination or treatment. I further authorize POLY Languages Institute to release my records to my agency, guardian, sponsor, and to any colleges or universities to which I apply.Do you understand and agree to the terms listed above? *Yes, I understand and agree to the terms listed above. WebsiteSubmit