Education Agent Application Form

USE THIS FORM TO EXPRESS YOUR INTEREST IN BECOMING AN EDUCATION AGENT FOR COLLEGE AUSTRALIA.

Please fill in the below form and hit submit.

First Name *

Surname *

Legal Entity *

Trading Name *

Business Number

Address

Address Line 2

City

Zip Code

State

Phone *

Email *

Website

Company Description

Please provide a description of your company *

Key Personnel

Please provide an overview of the key personnel within your company. Attach additional pages as required.

First Name *

Surname *

Position *

Background and Current Role *

Name *First

*Last

Position *

Background and Current Role *

General

Are you an authorised agent or member of an agent’s association?

What services do you provide or intend to provide to prospective students?

What is your main country of operations?

What are your Fees and Charges?

Referees

Referee 1

First Name *

Surname *

Relationship *

Phone *

Email *

Address *Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Referee 2

First Name *

Surname *

Relationship *

Phone *

Email *

Address *Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Additional Information

File Upload (Optional)

Browse

If you have any supporting documentation, please upload it here.

Comments (Optional)

Authorisation

By signing, I agree to adhere to the standards set out in the ESOS framework and by College Australia.

Draw signature|Type signatureClear

Please sign here with your mouse, stylus or finger.

CRICOS PROVIDER: 03513F | RTO NO. 31222

Save and Complete Later