AGENT APPLICATION FORM

Agent Company Details:

Agent Name

Business Trading Name

ABN

ACN

Date Of Registration

Migration Agent Registration Number

Postal Address

Country

Contact Number

Email Address

Website/URL

1. Contact Personal Details:

Title Title

Family Name

Given Name

Phone Number Work

Phone Number Mobile

Date Of Birth

Gender

Male

Female

Other

Position in Business/ Company:

2. Company Background:

Description of core business and whether recruitment of students is the main component of your business?

Number of years in business as a student Education Agent:

Number of students referred to Australian education institutions, and the type of courses enrolled in over the last three years:

Are there any judgments or orders against your company, or proceedings, applications for its winding up, dissolution, liquidation, or cessation of its business? Yes No If ‘Yes’ Provide details

Please list the services you provide or intend providing to students:

Do you charge students any service fees?

Yes

If ‘Yes’ Provide details of charges and for what service?

Which country/s will most of your student referrals originate from?

3. Profesional Referees

Referee 1

Name

Position

Organisation

Country

Phone Number

Referee 2

Name

Position

Organisation

Country

Phone Number

5. DECLARATION

I agree to and declare that I will:

a) Adhere to Education Services for Overseas Students (ESOS) Act 2000.

b) Regularly monitor policies and changes to the policies as reported on the DIBP (Department of Immigration & Border Protection) website.

c) Regularly monitor policies and regulations and changes to these policies and regulations as reported on the Department of Education website.

d) Regularly monitor The Australian Government Department of Home Affairs website.

e) Adhere to National Code of Practice for Registration Authorities and Providers of Education and Training to Overseas Students (2007) and agree to adhere to the relevant standards.

f) I confirm that I have all the necessary registrations, accreditations and permissions to act as an education agent in all the territories which I have nominated and understand that I must notify Solis College if any changes occur in the registration status of my agency.

g) I confirm that the answers and details provided are true and accurate to the best of my knowledge and I authorize you to approach referees to collect any information/details as you may request from time to time.

h) I comply with Solis College requirements for advertising, application procedures, and providing course material and other information to students.

i) I use only those materials supplied by Solis College to describe the Institute and its courses.

Agents Name

Date

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