_______________________________

(place and date)

_________________________________
_________________________________
_________________________________
(name and address of the institution)

_________________________________
_________________________________
_________________________________
(Name and address of the diploma/certificate holder)

ELIGIBILITY STATEMENT

We hereby confirm that __________________________________ (name of the educational

institution) is a recognized institution of secondary/ tertiary* education in
___________________________ (name of the country).
_________________________________ __________________________________ (name of
the diploma/ certificate) with the serial number _________________, has been issued on
__________________ (date of issue) in accordance with the law of
___________________________ (name of the country) and entitles its holder to pursue his/
her* education at the Bachelor/ Master* level in any University of the country where the
diploma/ certificate* has been issued and abroad.

___________________________________________
(name and signature of the authorized person)

_____________________________
(seal of the institution)

* delete as appropriate