Australian Institute of Higher Education P/L t/a AIH Higher Education
Level 4, 451 Pitt St, Sydney NSW 2000 Australia
Phone: +61 2 9020 8050
Fax: +61 2 8004 9286
Email: [email protected]
Web: www.aih.nsw.edu.au
CRICOS Provider Code: 03147A
Agent Application Form
Please complete all sections of this form in English. Applications will only be considered when ALL questions are completed and
ALL supporting documents have been supplied (checklist is on page 3). If your application is approved, an agreement will be
signed.
Business Details
Company Name:
Trading Name:
Business Registration Number:
Business Address:
Business Country:
Phone:
Email:
Website:
Directors Name:
Directors Email Address:
Key Contacts' Name:
Key Contacts Position:
Key Contacts' Email Address:
Key Contacts' Phone Number:
Marketing Details
How many years have you been trading in the
education consultancy industry?
Which countries do you recruit students from?
Is your office involved in any other business other
than student recruitment? (if yes, provide details)
Yes / No
Are you (or members of your staff) a member of any
professional organizations? (If yes, provide details)
Yes / No
Are you a member of MARA? What is your
registrationnumber?
What is your QEAC registration number?
How many staff members are responsible for
student consultancy in your company?
Have any of your staff studied or worked in
Sydney or Australia?
Has any of your staff visited Sydney? (please provide
details
How many of your staff are fluent in English?
Which Australian educational institutions do you
currently represent?
How many students has your company recruited in
the past year to study in Australia?
How do you propose to promote AIH Higher
Education?
Why do students choose your agency?
How is your organization different to other agents?
English
VET
Undergraduate
Postgraduate
Australian Institute of Higher Education P/L t/a AIH Higher Education
Level 4, 451 Pitt St, Sydney NSW 2000 Australia
Phone: +61 2 9020 8050
Fax: +61 2 8004 9286
Email: [email protected]
Web: www.aih.nsw.edu.au
Referees
CRICOS Provider Code: 03147A
Please nominate three (3) referees for us to contact. The referees should be people which you currently work with within the
Australian Education industry. Pleasenote that other agents will not be considered as valid referees. We prefer contacting
referees via email.
First Referee:
Name:
College Name:
Position:
Phone Number:
Email Address:
Second Referee:
Name:
College Name:
Position:
Phone Number:
Email Address:
Third Referee:
Name:
College Name:
Position:
Phone Number:
Email Address:
Declaration
I/We declare that the answers and information provided in this application are complete and accurate. I/We authorize Australian Institute
of Higher Education to contact my referees and the associated colleges in relation to the information which I have provided
I/We are aware that Australian Institute of Higher Education is under no obligation to accept this application to become an agent.
Name:
Company:
Position:
Date:
Signature:
Required Documents - in order to asses your application AIH Higher Education would require the following documents:
Company Profile
Business Registration Paperwork
Evidence of your memberships (QEAC,
MARA, ICEF)
Your promotional materials including
relevant links
Other documents you believe will support
your application
page 2 of 2
Revision:
2
Effective Date:
18 May 2015
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