中国科学院大学国际学生毕业结业肄业学位证明书申请表.docx

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1、中国科学院大学国际学生毕业/结业/肄业/学位证明书申请表APPLICATION FORM FOR GRADUATION/SCHOOLING COMPLETION/ATTENDANCE/DEGREE TESTIMONIAL*填写前请先仔细阅读说明内容。/Please carefully read the note at the end of the form before you fill in it.I 学生信息/Students Information学生姓名/Name学号/Student ID No.1寸免冠近照1 -Inch BareheadedPhoto Taken Recently护

2、照号码/Passport No.国籍/Nationality联系电话/Tel.邮箱/Email原证书编号/Reference Number of the Original Graduation Certificate/Certificate for Completion of Schooling/Certificate of Attendance/Degree CertificateII 申请信息(请选择)/Application Information (Please tick/) 申请办理毕业证明书/Apply for Graduation Testimonial; 申请办理结业证明书/A

3、pply for Schooling Completion Testimonial; 申请办理肄业证明书/Apply for Attendance Testimonial; 申请办理学位证明书/Apply for Degree Testimonial.HI 申请材料(提交前请详细检查)/Required Materials (Please carefully check before material submission)申请人当前有效身份证件复印件(如非中英文，请提供中英文翻译件)/Photocopy of the current valid identity document of th

4、e applicant (If the document is not in Chinese or English, please provide its English or Chinese translation with the original stamp of notary authority); 一张2寸蓝底与原毕业照同底片的照片(申请毕业证明书/学位证明书必备)/One 2-inch photo with blue background, same with that used in the previous Graduation/Degree Certificate (Requ

5、ired for Graduation/Degree Testimonial)IV 申请理 S/Personal Statement出于以下原因，提出本项申请/I submit this applications due to the following reasons：申请人承诺/I hereby promise that:申请人确为上述遗失/损坏证件学生本人；本人上述证件确实已经丢失/损毁。/I am indeed the above-mentioned student whose certificate have been lost/damage, and it is true that

6、 my above-mentioned certificate has been lost/damaged.为申请此证明书所提供的材料真实有效，否则因造假产生的一切责任由我本人承担。/The certificates and documents I offer for applying the testimonial from UCAS are valid and authentic, otherwise I will take all the consequences of fraud and forgery.申请人签字/Signature：年/Yr月/Mon日/DayV 培养单位意见 In

7、stitute/College Comment 对该生申请毕业证明书：同意Agree 不同意Disagree 对该生申请结业证明书：同意Agree 不同意Disagree 对该生申请肄业证明书：同意Agree 不同意Disagree经办人签字：年月日（主管部门公章）VI国科大意见UCAS Comment对该生申请在读证明：同意Agree 不同意Disagree经办人签字：年月日（主管部门公章）填表说明/Note：1.根据中国科学院大学学生管理规定，毕业证书、结业证书、肄业证书和学位证书遗失或者损坏的，由本人向培养单位提出申请，经国科大核 实后可以出具相应的证明书。证明书与原证书具有同等效力。A

8、ccording to the Regulations on Student Management of University of Chinese Academy of Sciences, in case of loss or damage of Graduation Certificate, Certificate for Completion of Schooling, Certificate of Attendance or Degree Certificate, the students can file an application to their host institute,

9、 which should then apply for the corresponding testimonial from UCAS, which will be issued after verification. The testimonial has the same effect as the original certificate.2.本表由申请者本人填写，在培养单位盖章后，连同相关材料的扫描件发送至。/This form shall be filled by the applicant with a I-inch bareheaded photo.It shall be submitted after host institutes review with other required materials to .