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PRC ID No. /Passport No.
申请人中文和英文签名日期
Signature Date