Document Request Form

Student Name *

First

Last

Email *

Confirm Email

Phone *

Date of Birth *

Which School Location? *

POLY Languages at Irvine
POLY Languages at Los Angeles

If 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.

Certificate

Certificate 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.

Transcript

Official 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 It includes all courses attempted at POLY Languages Institute, including those withdrawn from and those repeated.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 ID

Student 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.

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 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Message

Total Due:

$0.00

Assisted by (Optional)

State the name of the advisor who assisted you in completing this form.

Stripe Credit Card *

Card

Name on Card

Acknowledgement 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.