海外学历认证授权模板

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, __________, 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 PRC ID No. /Passport No.

申请人中文和英文签名

日期

Signature

Date