授权信及真实性声明
AUTHORISATION LETTER
According to information protection code of the UK, we ask all applicants to fill this letter in
English and sign at the bottom 基于英国信息保护法要求申请人用英文填写相关部分并签名
中介填写 For Agent Use Only
Agent Name
Agent Email
Institute Name
Applied Course
App ID/UCAS ID
Date YMD
Note 注: Date - prior to the date of application 日期必须填写申请提交之前的日期
学生填写 For Applicant Use Only
姓 FamilyName:
Shen
生日 DOB：年月日
名 First Name:
国籍 Nationality：
Xinyi
Chinese
Upon receipt of the agent authorization letter, I authorize the above named agent to act on my
behalf for all matters that concern my application to your institute. All future correspondence
concerning my application will be sent to the named agent.
我确认委托上述中介为我提供入学申请等相关事宜的办理服务，并授权海外校方披露所有关
于本人入学申请的相关信息给上述中介。
I am requesting that the agent provides me with counseling/advice regarding my application/visa
(delete as appropriate).
我要求上述中介为我提供了入学申请、签证咨询办理服务（没有提供的请划掉）
I fully understand the position of anti-forgery of Overseas Institutions. I herewith certify that all
the documents submitting to above agent, for university or school application are authentic to
the best of my knowledge, for which I will take full responsibility.
我清楚了解国外大学反对虚假材料的立场，针对我所提交所有申请材料,我承诺并保证所有
申请材料全部是真实的，并对此负责。
I
understand that all correspondence relating to my application and the
personal data contained in this will, as a consequence of my consent, be shared with
.
我已知晓并同意，所有与申请有关的材料、函件及个人信息，均与本授权书中指定的代理共
享。
学生签字(Signature of applicant)