AGENT APPLICATION FORM

Step 1 of 3

Name

This field is for validation purposes and should be left unchanged.

Company Details

Legal / Entity Name(Required)

ABN if Applicable

Trading Name(Required)

Website

Head Office Address(Required)

Street Address State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Company Profile

Year Established(Required)

Number of Staffs(Required)

Number of Students Recruited Each Year(Required)

Main Student Nationalities Recruited(Required)

Main Australian RTOs Represented(Required)

Branch Office Locations (List Cities)(Required)

Industry Associations (optional)

Which Countries Do You Recruit Students

List of countries and years recruiting students(Required)

country

Numbers of Years recruiting from this country

Click the + to add more rows

Principal / Owner

Name(Required)

Prefix First Last

Job Title(Required)

Email(Required)

Office Phone(Required)

Mobile Phone(Required)

Key Contact Person

Key Contact Same as Principal Owner?(Required)

Key Contact Name(Required)

Prefix First Last

Job Title(Required)

Email(Required)

Office Phone(Required)

Mobile Phone(Required)

Marketing

What strengths do you believe SC has that will allow you to promote it as a choice of educational institution for overseas students?

How many students do you believe you will be able to recruit for SC in the first year of representation?

what do you need from SC to help you promote it as a choice of educational institution for overseas students?

Have you and key agency staff read the National Code of Practice for Registration Authorities and Providers of Overseas Education and Training to Overseas Students 2007?(Required)

Do you and key agency staff have a sound knowledge of DIPB regulations and Genuine Temporary Entrant criteria?(Required)

Have you and/or key agency staff done PIER’s Education Agent Training Course (EATC)?(Required)

Are you and/or key agency staff Qualified Education Agent Counsellors (QEAC)? Yes No(Required)

Are you and/or key agency staff registered migration agents?(Required)

Please specify if you have completed any other industry training

Referees

Please provide two referees including at least one Australian education provider:

Referee 1

1st Referee Name(Required)

Prefix First Last

Job Title(Required)

Email(Required)

Office Phone(Required)

Mobile Phone(Required)

Referee 2

2nd Referee Name(Required)

Prefix First Last

Job Title(Required)

Email(Required)

Office Phone(Required)

Mobile Phone(Required)

Supporting Documents

SUPPORTING DOCUMENTS

Please attach the following documents in support of your application:

Business registration certificate (offshore agencies only)
Company Profile
Evidence of staff training and knowledge (ETAC and ASVP preferred)
Registered migration agent certificate/s, if applicable
Referee letters if available
List of branch offices with contact details, if applicable

Supporting documents files upload(Required)

Drop files here or

Max. file size: 64 MB.

Declaration

Signature(Required)

Name(Required)

Position(Required)

Date(Required)