申請美國學歷查證用授權信

Letter of Authorization

(for U.S. academic record release)

To Whom It May Concern:

I, _______________________________________________________ (full name in English and Chinese), Social Security No. ____________________ , Student ID No. ________________________ , hereby waive my rights under the Rights of Privacy Act and authorize the release of all information relevant to my academic record at ___________________________________________ (school name) located at ___________________________________________________________________ (full address) to the Taipei Economic and Cultural Office in New York (TECO-NY), located at 1 East 42nd Street, New York, NY 10017.

I authorize TECO-NY to check my admission requirements and verify if I’m pursuing the academic degree by way of distance learning, internet course, or studying at an associated college or validated course in the US or overseas.

Yours faithfully,

_________________________________________ (signature) _____________________________ (date)