学历认证授权书模板

声明

本人，授权及同意中国留学服务中心（CSCSE）使用本人的个人信息和资料，向相关学校或机构就本人学历学位的有关事项进行核查。同时也授权并同意相关学校或机构可就核查内容，向CSCSE透露有关本人学历学位的任何记录及资料。

Declaration

I, undersigned, hereby give my consent to the Chinese Service Center for Scholarly Exchange（CSCSE）to use my personal information for the purpose of education/degree verification with any relevant schools/organizations(e.g., Hedd in UK, NSC in US, AURADATA in Canada, or Verifdiploma in France, etc). I also give my consent to the mentioned above schools/organizations to release my record or information to CSCSE as required.

姓名Name 出生日期DoB

学号Student ID

证书名称Qualification Type

就读专业Major/Field of Study

学习时间Period of Study

身份证号/护照号（港澳台地区认证需填写往来港澳通行证号/往来台湾通行证号）PRC ID No. /Passport No.

申请人中文和英文签名日期

Signature Date