Agency Information

Agency Name:*
Business Registration No:
Agency Telephone No.*
Agency Fax No..:
Head Office Location:*

Agent Information

Main Contact - First Name*
Main Contact - Last Name:*
Main Contact E-Mail Address:*
Marketing Country*
How many offices do you have?*
Which cities do you have offices in?*
When was your agency established?*
Which countries do you recruit students from?*
How many students have you sent to Canada in the past 12 months?*
Which methods do you use to recruit students?*
How did you learn about us?*
Please Specify:*
(If Other)


Please provide names and contact information for two educational institutions you have worked with as an agent

Reference #1

Reference 1: Institution Name*
Reference 1: Contact Name*
Reference 1: City, Country*
Reference 1: Phone*
Reference 1: EMail*

Reference #2

Reference 2: Institution Name*
Reference 2: Contact Name*
Reference 2: City, Country*
Reference 2: Phone*
Reference 2: Email*

Please upload your Business Registration Certificate here:

1.    Click Browse and locate the file on your PC
2.    Select the file you would like to upload
3.    Click Upload File
4.    Click Submit

Upload Documents*
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