Online Evaluation Form

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Provide Details


	You have currently chosen to be evaluated for our ‘High School Diploma Package’ . To continue with the evaluation process, kindly provide the required information in the fields given below.

Briefly type the work or life experience that qualifies you for this diploma.*

You may type/copy-paste your resume here which will help our evaluation committee understand your work/life experience better.

Alternatively, you can browse and attach your resume from below.

Browse and attach your resume.

•Preferred Year of Graduation


	Please select your preferred date of graduation from below. If approved, your selected date of graduation will appear on your diploma, transcript and other documents included in the package. Currently, September 4, 2010 has already been selected as the date of your graduation. If you wish to select any other year of graduation, kindly select from below .

High School Diploma Package

Pre-Selected Graduation Date: September 4, 2010

Your Preferred Graduation Date: ,

•Grade Point Average (GPA)

Please select your preferred GPA/Grade Status from below. Your selected GPA/Grade Status will be displayed on your Diploma and Transcript. A GPA/Grade Status of 3.00 has already been selected for your High School Diploma . If you wish to select any other GPA/Grade Status , kindly select from below.

GPA 3.00

GPA 3.4 – 3.6 (Cum Laude)

GPA 3.61 – 3.89 (Magna Cum Laude)

GPA 3.9 – 4.00 (Summa Cum Laude)

Personal Information

*( indicates the required fields)**
Name:* (Provide the name you want to appear on your Diploma and Certificates)
Date of Birth: * (Example: January 14, 1976)	,
E-mail:* (To make sure that you get timely evaluation result from us, just add our e-mail to your address book or allowed sender list. Click here to read the instructions for adding care@belfordhighschool.org to your address book)
Alternate E-mail: (Optional) (Provide an alternate e-mail address where we can contact you. This address should be different from the one given above.)

Shipping Information

Street Address:*
City:*
State / Province:*	If other than above then Type
Zip / Postal Code:*
Country:*
Telephone Number:* (Your permanent telephone number)	Ext:
Telephone Number: (Optional) (The telephone number of the location where you are currently available, if different from above.)	Ext:
Fax:

You may now click 'Submit' button to preview your evaluation details.