[PLEASE TYPE OR PRINT CLEARLY]

Certificate of English Language Instruction

at Secondary Education Institution

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This certificate is to be completed ONLY for students who attended a high-school where English was the primary
language of instruction. This includes students from countries where English is recognized as an official language.

While students from these countries are not required to submit TOEFL scores, they will be assessed by NEO’s
standard entry Computerized Placement Tests (CPT).

If you attended an English-speaking high school, this form must be validated by a school official.
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I certify that

________________________________________________________________________
[Student Name]

completed a secondary degree from

________________________________________________________________________
[Institution Name]

which is an educational institution where English is the language of instruction.

Name [Please Print]: ____________________________________________________________

Permanent Mailing Address: ______________________________________________________
______________________________________________________________________________
Phone Number:__________________________ Fax Number: ___________________________

“I hereby certify that the above information provided for applicant is a true and accurate statement.”

_______________________________________________________________________________________
Signature: Date:

________________________________________________________________________________________
Title: Organization Name: