September 12, 2011

Educational Commission for Foreign Medical Graduates (ECFMG)

3624 Market Street
Philadelphia, PA 19104-2685

To Whom It May Concern:

I would like to submit the attached documents in which the Medical School of (Name
of Medical School, in CITY – COUNTRY, determines the authorized officials who
may sign documents used for purposes related to the Educational Commission for
Foreign Medical Graduates (ECFMG). Please note the stamps and seals that should be
used by authorized officials are designated in a separate document.

Sincerely,

_____________________________
Signature

NAME, MD
Medical School Director (or other title)
UNIVERSITY
September 12, 2011

Educational Commission for Foreign Medical Graduates (ECFMG)

3624 Market Street
Philadelphia, PA 19104-2685

To Whom It May Concern:

I would like to appoint the following individuals as Officials Authorized to verify the status of
students and graduates of the Medical School of the NAME OF UNIVERSITY, in CITY –
COUNRTY, for purposes related to the Educational Commission for Foreign Medical
Graduates (ECFMG).

Officials Authorized:

FULL NAME TITLE SIGNATURE

1.

Sincerely,

_____________________________
Signature

NAME
TITLE (RECTOR OR DEAN)
UNIVERSITY
September 12, 2011

Educational Commission for Foreign Medical Graduates (ECFMG)

3624 Market Street
Philadelphia, PA 19104-2685

To Whom It May Concern:

I would like to submit the following stamps and seals of the Medical School and of
authorized officials of the UNIVERSITY, which may be used for purposes related to
the Educational Commission for Foreign Medical Graduates (ECFMG).

Medical school stamps and seals

Medical school authorized officials’ stamps and seals

Sincerely,

_____________________________
Signature

NAME
TITLE (RECTOR OR DEAN)
UNIVERSITY