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AGENT APPLICATION FORM
Company Name :
*
Trading Name :
*
ABN or ACN (if any):
*
Enter Telephone :
*
Enter Mobile :
*
Enter Email Id :
*
Enter Website :
*
Company/Business Street Address :
*
Company/Business Postal Address :
*
Names of all Directors :
*
Name of Registered Owner/Principal :
*
Name of Chief Executive Officer (if different) :
*
Agent’s Migration Agents Registration Number (If an agent is Registered Migration Agent) :
*
Following Information of Agents’ Employees (If Any) who are involved in facilitating an Enrolment
Sr.no.
Name
Email Address
Migration Agent Registration Number (If registered with OMARA)
1
+Add More
Company information:
How long has your company been in existence?
*
Branches:
*
Description of your major business activities:
*
Services provided to students:
*
Number of students sent abroad per year:
*
Countries students are sent from:
*
Name any 3 Institutions / Colleges currently representing:
*
What professional associations are you a member of?
*
Number of students you estimate to recruit for Yarra College Australia over the next 12 months:
*
Have you ever had a previous education agent agreement cancelled by a RTO?
Yes
No
Please provide us with a sample or your organisation’s promotional materials and advertisements (English and any other applicable languages) - attach the documents (if available)
Please attach the following to your application:
Business Registration Certificate
Copy of your company profile
Samples of marketing material distributed by your agency
Copy of Register of company
Copy of MARA Certificate
Business Registration Certificate :
*
Copy of your company profile :
*
Samples of marketing material distributed by your agency :
*
Copy of Register of company :
*
Copy of MARA Certificate :
*
PLEASE PROVIDE CONTACT DETAILS OF TWO REFEREES (Preferably Australian education providers or alternatively, business referees): *Please Note these referees will be contacted
First Reference
Name:
*
Position:
*
College/Institution Name:
*
Phone:
*
Email:
*
Second Reference
Name:
*
Position:
*
College/Institution Name:
*
Phone:
*
Email:
*
PLEASE READ THE FOLLOWING CAREFULLY
I/ We understand that submitting this ‘Agent Application Form’ to Yarra College Australia, does not grant or guarantee registration as an agent for recruiting domestic and / or international students.Yarra College Australiareserves the right to cease all business dealings with me / us if we mislead prospective students or misrepresent Yarra College Australia as authorised agents or representatives of Yarra College Australia.
I/We prepared to enter into an agreement with Yarra College Australia
All the information provided above is true and accurate.
I am interested in representing Yarra College Australiaas an education agent and I agree to do so in an honest and professional manner as per the National Code of Practice for Registration Authorities and Providers of Education and Training to Overseas Students (The National Code) and the ESOS Act 2000
https://internationaleducation.gov.au/Regulatory-Information/Education-Services-for-Overseas-Students-ESOSLegislative-Framework/ESOS-Regulations/Pages/default.aspx
Applicant’s signature:
Applicant’s Name :
*
Applicant’s Position:
*
Date:
*
Submit