FORM :MKT 03.002 Agent Application Form Version No. 1

AGENT APPLICATION FORM
HOW TO APPLY

Please complete this form and return it to us with the supporting documents. E.g. Company registration certificates, company profile (if applicable) &etc. by email to the college.

*Please note Agent agreement and Agent certificate may take up to 2 weeks from the submission of this form.Please note that if successful, the Agent Agreement will apply for selected Providers only.
CONTACT US

Sydney Campus : LG, 101 Sussex St. Sydney NSW 2000 Australia
Brisbane Campus: Level 5, 316 Adelaide St, Brisbane QLD 4000 Australia

T: +61 2 9283 4388

E: info@wic.edu.au

www.wic.edu.au
1. Company Details
Agent Name
Business Legal Name
Business Trading Name
ABN/ACN
Business Registration Authority
Migration Agent AuthorityNumber(MARN):
Postal Address
Postcode
Country
Website
Is your postal address is different than your business address

Yes No
How long has your business been operating?
Number of staff/counselors
Detail membership of professional associations
Detail specific International recruitment training undertaken
Number of students referred to Australian educational institutions over the
past 3 years.
High School/ELICOSblanks Undergraduateblank TAFE Postgraduate RTO

5. Proposal
Please outline the support services you can offer to students
What is the most suitable time of the year to conduct a visit to your office?
Please use the space provided below to include any other information
Please list the names of two (2) referees who can vouch for you and your company’s financial standing and their contact details.
1. Referee Name
From
Contact Number

Area Code Phone Number
Email
example@example.com
2. Referee Name
From
Contact No

Area Code Phone Number
Email
example@example.com
OFFICIAL USE ONLY
Received By
Position
Supporting Documents Checklist:

Certificate of Company Registration ABN Registration Company Profile (if Capable) Other Document Other
Agreement Issued By
Date

Day Month Year
Date
Creating RTO Profile
Agent Certificate issue by, Name blanks Date Date
FORM : MKT 03.002_Agent Application Form LAST UPDATED : Aug 2018, Version No.1
Should be Empty:

AGENT APPLICATION FORM