NEG Education Application Form

Education Agent Application Form

SC7. 2-1 Please complete all sections on this form, contact info@zoi.vic.edu.au if any issue to complete the form. Please choose which college you would like to apply for the partnership. Thank you.
ZOI Education ONLYINUS English ONLYZOI Education and INUS English together
Company Details and Background
Business Information

Business NameTrading Name (if different from business name)
Business Registration NumberYear of Establishment
Director NameDirector Email Address
Main E-mail
example@example.com
Main Office Number
Website
Main Office Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Markets and Services to be Provided
What is your target markets for Zoi Education? (Regions or countries)
What marketing strategies will you use to promote our courses?
Outline any support services that you offer prospective students.
Do you charge students any fees for your services? (Yes / No)
If yes, please provide details of the services and relevant fee for each.
Agent Performance and Compliance
How many Australian education institutions are you currently representing?

How many students have you referred to Australian education institutions in past 12months?

	0-10	11-20	21-30	31-40	41-50	50+
ELICOS
VET
Higher Education

Outline how you and your organisation fulfil your responsibilities as an education agent as required by the National Code of Practice 2018. Attach supportive documents if applicable.
Have you or your staff completed the Education Agents Training Course (EATC) via www.pieronline.org?

YesNo
If Yes, provide the certified person's name and QEAC code.

Monitoring

	Yes	No
Do you have a comprehensive understanding of the requirements of the ESOS Act and National Code?
Do you regularly monitor the Australian Department of Immigration and Citizenship website and the Department of Education?
Are you willing to comply with the requirements of Zoi Education regarding advertising, course materials and application procedures, and provide accurate information to students?
Are you prepared to use the marketing materials provided by Zoi Education to promote our courses?

Additional Information
Please provide any other information that you think will support your application.
Branch Info 1: Name of Main contact      Full Name . Email Address:   Email . Contact No      Phone Number .

Branch Info 2: Name of Main contact      Full Name   . Email Address:     Email  . Contact No Phone Number.

Branch Info 3: Name of Main contact   Full Name. Email Address:   Email    . Contact No    Phone Number .
Please provide 1. Business Certificate, 2. Office Photos, 3 Company Profile, 4. PIER/MARA/ISAN and/or any documents which can support your application
Cancelof
Reference

At least 2 Referees OR agent certificates from Australia Institute must be provided.
Institute 1

Institute Name

Contact Person's Name and Position

Email AddressPhone Number

How many years you have worked with this institute?
Institute 2

Institute Name

Contact Person's Name and Position

Email AddressPhone Number

How many years you have worked with this institute?
Documents: Valid Agent Certificate from Australian Institute if applicable

Cancelof
Declaration

In signing this agreement, you declare that; 1 You have read and understood the extract from the ESOS Act 2000 Obligations of Agents. 2 The answers and details provided in this application are true, accurate and complete. 3 Zoi Education is authorised to contact the referees listed to collect information about my conduct and services. 4 You acknowledge and agree to the privacy statement provided below. Privacy Statement: All information collected, used or disclosed by Zoi Education is confidential and is protected by the Privacy Act 1988 and other relevant legislation. Zoi Education policy is outlined in the Information Privacy Policy available from our website. Information about Agents or students may be made available to Commonwealth and State agencies if required to provide the information by law.
In NEG team, who is/will be your main contact

Veronica (Korean, English) - Head of MarketingMaria (Spanish, English) - EU and Onshore LATAMBo (Thai, English) - South East AsiaJerry (Chinese, English) - Chinese and South AsiaI don't know the main staff at NEG, please allocate one for usOther
Signature*

Powered by Jotform SignClear
Signature Date*

DayMonthYear
Date
Who is the best contact staff at ZOI for your agent?
Name our staff who works with your agent. (For example, Daniela, Veronica or type ' I don't know yet'
Should be Empty:

Education Agent Application Form

Company Details and Background

Markets and Services to be Provided

Agent Performance and Compliance

Reference

Declaration