1、声 明#本人, 授权及同意中国教育部留学服务中心可就我本人学历学位认证的有关事宜向相关机构或组织透露本人的个人资料并对本人取得国(境)外学历学位证书及高等教育文凭的情况进行核查。#同时也授权相关组织或机构可就这些核查内容,向中国教育部留学服务中心透露任何有关的记录及资料。#Declaration#I, authorize and consent to the Chinese Service Center for Scholarly Exchange (CSCSE)making any enquiries, which requires releasing my personal informa
2、tion, for purposes relating to qualification evaluation. I also authorize and consent to relevant organizations/schools to release my record or information to the CSCSE as may be required for these enquiries. #个人信息 Personal Data (以下信息请用英文填写)#姓名(Name) 出生日期(DoB) #学号(Student ID) #就读课程(Programme of Study)#学习时间(Period of Study)#申请人签名 日期#Signature of the applicant Date #