Agent Application Form

Agent Application Form

Note: Please complete all sections of this form in English. Applications will only be considered when ALL questions are completed and all supporting documentation is supplied. Please attach translated and certified copies of your business registration certificate(s).
Choose the Albright Representative (Marketing Manager/ BDM) looking after your account*

Carlos PlataNatalia SanzHaruna YamanoDaniela OchoaJenny YangNadira PujiOther

Registered Business Name*
Trading Name (if any)
Business Registration Number (country of origin)*
Australian Business Registration Number (if applicable)
MARA Registration Number (if applicable)
Key contact person(s) (CEO / Director)*
Key contact person(s)*
Registered Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Telephone/Mobile*

Country CodeArea CodePhone Number
Agent Email*
example@example.com
Website Address*
www.website.com
Australian Bank Account Details (if applicable)
Account Name
Bank Name
BSB
Account Number
Overseas Bank Account Details (if applicable)
Account Name
Bank Name
Bank Address
Country
Account Number
SWIFT Code

Referee 1
Organization Name*
Contact Person Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Referee Email*
example@example.com
Referee 2
Organization Name*
Name*

First NameLast Name
Referee Email*
example@example.com
Phone Number*

Area CodePhone Number

Is your office involved in any other business activities other than student recruitment?*

YesNo
Please provide details of the other business activities
Which Australian educational institutions do you currently represent? State at least 3 institutions.
Institution 1*
Institution 2*
Institution 3*
Do you have additional offices/branches?*

YesNo

Additional Offices/ Branches

Rows	Office/ Branch Name	Branch Address	Branch Contact Person
Branch 1
Branch 2
Branch 3
Branch 4

Do you use sub-agents or other people not employed directly by you to perform student recruitment activities?*

YesNo
If yes, do you ensure such sub-agents and or individuals are aware of and comply with recruitment agent obligations under the ESOS Act and National Code 2018?

YesNo
Which services do you provide to students? (Please tick the appropriate boxes)*

Student counsellingFollow up with parentsHome stay/guardianshipEnglish testingCollecting feesVisa applicationPre-departure briefingOther

How do you propose to promote Albright Institute of Business and Language? (Please select the appropriate boxes))*

BrochuresExhibitionsInternetEducation Agent WebsiteStudent SeminarsOther
Name up to three destination countries that the majority of your recruitment comes from
Country 1

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Country 2

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Country 3

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Name the top 3 courses that students from your agency opt for?
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How many students do you expect to send to Albright Institute of Business and Language each year?*

Company information including company profile, organisational chart and marketing profile*

Browse Files

Cancelof
Evidence of business registration*

Browse Files

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MARA Certification

Browse Files

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Student testimonials (if available)

Browse Files

Cancelof
Other supporting documents (e.g. industry associations, memberships, etc.)

Browse Files

Cancelof
Supporting promotional materials/information provided to international students, including website URL

Browse Files

Cancelof

I/we declare that the answers and information provided in this application are complete and accurate and that all information pertaining to this application has been fully disclosed, irrespective of whether or not such information was specifically requested.

I/We declare that I/we understand all relevant laws and regulations of Australia and of the countries where we recruit students, in particular those laws pertaining to Australian consumer protection, the ESOS Act and the National Code 2018. Also agree to regularly view the Department of Home Affairs website to monitor policies and any changes to the policies.

I/We confirm that I/we have appropriate knowledge and understanding of the international education system in Australia, including the Australian International Education and Training Agent Code of Ethics.

I/We confirm my/our obligation to comply with such laws and regulations at all times, including any amendments.

I/We confirm my/our obligation to observe appropriate levels of confidentiality and transparency in our dealings with overseas students or intending overseas students and act honestly and in good faith, and in the best interests of the student.
Applicant's Role or Tittle in The Organisation*
Applicant's Name*

First NameLast Name
Applicant Signature*
Date*

DayMonthYear
Date
ANIT Australia Pty Ltd T/A Albright Institute of Business and Language RTO #: 45041 CRICOS #: 03553J www.albrightinstitute.edu.au

Head Office Address: Level 2,4 & 8, 341-345 Queen Street, Melbourne VIC 3000 Tel: 1300 189 154 Campuses at: Sydney, Brisbane, Adelaide

MARK-FORM01 Agent Application Form | Version: 2 | Last Reviewed: August 2022 | Next review Date: As required
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