1、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。DeclarationI, 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 verificat
2、ion 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.个人信息 Personal Information (以下信息请用英文填写 )：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
