留学中心声明模板通常包括以下内容：
基本信息
姓名（Name）
出生日期（Date of Birth）
学号（Student ID）
就读课程（Programme of Study）
学习时间（Period of Study）
授权内容
授权人同意中国教育部留学服务中心（CSCSE）使用其个人信息和资料，向相关学校或机构就学历学位的有关事项进行核查。
授权人同意相关学校或机构向CSCSE透露其学历学位的任何记录及资料。
授权范围
明确授权的范围，包括对学历学位认证的有关事宜进行核查，并允许相关机构或组织透露必要的记录及资料。
保密条款
授权人同意CSCSE和相关机构对个人信息和资料进行保密，不得泄露给任何第三方。
签名和日期
授权人需在声明末尾签名并注明日期。
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Declaration
I, the 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.
Personal Information:
Name: [Your Name]
Date of Birth: [Your Date of Birth]
Student ID: [Your Student ID]
Programme of Study: [Your Programme of Study]
Period of Study: [Your Period of Study]
Consent:
I consent to the CSCSE using my personal information for the purpose of education/degree verification with relevant schools/organizations.
I consent to the release of any records or information related to my education/degree to the CSCSE as required.
Scope of Authorization:
The authorization includes the verification of my education/degree and the release of any necessary records or information to the CSCSE.
Confidentiality:
I agree that the CSCSE and any relevant schools/organizations will keep my personal information confidential and will not disclose it to any third party.
Signature and Date:
[Your Signature]
[Today's Date]
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请确保在填写声明时，所有信息均准确无误，并且签名和日期为手写或电子签名。