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:*

(If Other)

References

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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