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THIRD-PARTY AUTHORIZATION LETTER

I, _________________________________, the undersigned, do hereby authorized, NEAC

Medical Exam Application Center its agents or employees, ____________________________
whose address is:

NEAC Medical Exams Application Center

2F St. Thomas Sq. 1150 Esapana Blvd
Cor. P. Campa Sampaloc Manila, PH 1008

to act for me and in my name with respect to my international exam application requirements.

✓ Apply my school credentials (TOR, RLE, Course Description).

✓ Pay all the credential fees.
✓ Act as my representative on all matters with the School and PRC.
✓ Apply for my license verification, license renewal, certification at (PRC).

________________________ _______________
Signature over Printed Name Date

2f St. Thomas Square 1150 Espana Blvd. Sampaloc Manila Philippines 1008
MANILA- CEBU - USA - SINGAPORE

www.medexamcenter.com