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,herebygivemyconsenttotheChineseServiceCenterforScholarlyExchange(CSCSE)tousemypersonalinformationforpurposeofeducation/degreeverificationwithanyrelevantschools/organizations.Ialsogivemyconsenttothementionedaboveschools/organizationstoreleasemyrecordorinformationtoCSCSEasmayberequired.个人信息PersonalData(以下信息请用英文填写)姓名(Name)出生日期(DoB)学号(StudentID)就读课程(ProgrammeofStudy)学习时间(PeriodofStudy)申请人签名日期SignatureoftheapplicantDate