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EduCo Agent Application Form* Please forward a copy of your
Current Business Profile along with this Agency Agreement
Application Form
Company name:
Current EduCo agent? Yes No
If yes, which institutions are you currently representing?
Southern Cross University Strathfield College
Cambridge International College Baystate College University of
St. Thomas Arbutus College
Head Office Details:
Contact name:
Position:
Office address:
State/Province/District: Postcode/Zip:
Postal Address (if different):
State/Province/District: Country: Postcode/Zip:
Phone: Fax:
Email(s):
Website:
Agent Information:
Year Agency was founded:
Years in recruitment:
Total number of staff:
Number of students recruited per year:
Number of students recruited to which countries each year:
What other institution do you represent?
Have you worked in conjunction with any other agents?
If yes, what is the name of the other agency(s)?
What services do you offer to students?
Head Office: 422 Little Collins Street, Melbourne, Victoria,
AustraliaPh: +61 3 9663 4933 www.educoglobal.com
Document: Agency Agreement Application Form National Code 2007
Standard 4Approved by: CEO Version date: 6 May 2015: Ver 1 Replaces
version dated: 10 October 2007 Page number 1
Country:
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Head Office: 422 Little Collins Street, Melbourne, Victoria,
AustraliaPh: +61 3 9663 4933 www.educoglobal.com
Document: Agency Agreement Application Form National Code 2007
Standard 4Approved by: CEO Version date: 6 May 2015: Ver 1 Replaces
version dated: 10 October 2007 Page number 2
Please list other offices that operate under your Agencys name:
(Please attach another sheet if required)
Other offices:
Office name:
Contact name:
Position:
Office address:
State/Province/District: Country: Postcode/Zip:
Postal address (if different):
State/Province/District: Country: Postcode/Zip:
Phone:
Fax:
Email(s):
Website (if different):
Office name:
Contact name:
Position:
Office address:
State/Province/District: Country: Postcode/Zip:
Postal address (if different):
State/Province/District: Country: Postcode/Zip:
Phone:
Fax:
Email(s):
Website (if different):
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Please name two referees from Educational Institutes that your
Agency currently represents.
Referee one:
Contact name:
Name of Educational Institute:
Position:
Phone:
Fax:
Email:
Referee two:
Contact name:
Name of Educational Institute:
Position:
Phone:
Fax:
Email:
Declaration:I am interested in representing the below
institutions as an education agent and I agree to do so in an
honest and professional manner. I declare that the above
information I have provided is correct and true.Please check the
appropriate box.
Name: Signature: Date:
USA
Claremont, California
Head Office: 422 Little Collins Street, Melbourne, Victoria,
AustraliaPh: +61 3 9663 4933 www.educoglobal.com
Document: Agency Agreement Application Form National Code 2007
Standard 4Approved by: CEO Version date: 6 May 2015: Ver 1 Replaces
version dated: 10 October 2007 Page number 3
Boston, Massachusetts Lincoln, Nebraska Boston,
Massachusetts
CRICOS Sydney & Melbourne 01241G CRICOS Melbourne 01718J
Perth 01459A CRICOS Sydney 02736K Vancouver DLI O19219834012
Australia
St. Paul & Minneapolis, Minnesota
Canada
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bscfas:
