留学生学位认证授权书.doc

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 verificatio

2、n 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： Chang Liu 出生日期DoB ：10/07/1992 学号Student ID : 11840321 证书名称Qualification Type: Bachelor of Business就读专业Major/Field of Study: International Business学习时间Period of Study: 2014-032016-08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.130105199207102117/ G47595028申请人中文和英文签名 日期Signature Date