School Name 学校名称 ____________
School Address 学校地址 ____________
Dates of Attendance Start 开始时间 (MM/YY) ____________
Dates of Attendance End 结束时间 (MM/YY) ____________
Degree Obtained 学位名称 ____________
Name of Credential Program 课程名称 ____________
School Telephone 电话 ____________
School Email ____________
Your Name(As it appears on the credential) 认证人名称 ____________
Your Student ID 学生ID ____________