Agency Information

Agency Name:*
Business Registration No:
Agency Telephone No.*
Agency Fax No..:
Head Office Location:*
Address1:
Address2:
City:
Province/State:
Postal/ZipCode:
WebSite:

Agent Information

Main Contact - First Name*
Main Contact - Last Name:*
Position:*
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:*

References

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

Reference 1: Institution Name*
Reference 1: Contact Name*
Reference 1: City, Country*
Reference 1: Phone*
Reference 1: EMail*
Reference 2: Institution Name*
Reference 2: Contact Name*
Reference 2: City, Country*
Reference 2: Phone*
Reference 2: Email*
By submitting this form, I agree that IBT College may call, text and/or email me about their educational services