Education Agents Application Form

Education Agents Application Form
DOCUMENTS CHECKLIST
Please attach, tick & fill the following documents to support your application*

Copy of business registrationA profile outlining your agency’s services and credenalsA proposed markeng plan of how you intend to recruit students for AIA (if applicable)A list of all sub-agents including the agency name, agency website, details of the term of their appointment, contact name and contact information (if applicable)
File Upload*

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YOUR AGENCY LOGO

If applicable
Please upload your Agency's Business Logo:

Please make sure to upload the Full HD file(s) - your logo will be published on AIA website, once approved.
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Part A: Company Details & Background
Type of Legal Entity*
Company/Business Name*
Do you have a different Trading Name of your business?*

YesNo
Trading Name*
Are you an Australian Registered Company or Overseas?*

Australian RegisteredOverseas Registered
Please provide your ABN*
Please provide your ACN
Business Registration Number*
Business Address*

Street Address

CityState

Postcode / Zip CodeCountry
Business Email*

Confirmation EmailPlease make sure you enter the same email address here
Business Phone Number*

Country CodePhone Number
Business Website Address
Year of Establishment*
Number of Offices*
Number of Staff*
Countries of Offices
Please describe your business activities*

PART B: Director/Main Contact & MARN Details
1. Director / CEO Details
Main Contact Position*
Name*

PrefixFirst NameLast Name
Qualifications & Previous Experience*
Memberships of Education Agent Professional Bodies (if any)
2. Director / CEO / Employee Details
Second Contact Position
Employee Designation*
Name

PrefixFirst NameLast Name
Qualifications and Previous Experience
Memberships of Education Agent Professional Bodies (if any)
Would you like to provide details for another contact?

YesNo
Person 3 - Director/CEO or Employee
Third Contact Position
Employee Designation*
Name

PrefixFirst NameLast Name
Qualifications and Previous Experience
Memberships of Education Agent Professional Bodies (if any)
Registered Migration Agent (MARN) Details

if applicable
Do you have any employee/staff/contractor and/or sub-contractor including yourself, a registered migration agent (MARN)?*

YesNo

PART E: Academic References

Please list the names and contact details of two (2) professional referees you represent:
Note: If you are currently representing any Australian Institutions, please make sure to include their reference below.
1. Institution Name*
Contact Person Name*
Position*
Phone Number

Country CodePhone Number
Email Address*
example@example.com
2. Institution Name*
Contact Person Name*
Position*
Phone Number

Country CodePhone Number
Email Address*
example@example.com

PART F: Declaration
In signing this form, you declare that*

You have read and understood the extract from the ESOS Act 2000 Obligations of Agents;The answers and details provided in this application are true, accurate and complete;Auscanus Institute of Australia is authorised to contact the referees listed to collect;You acknowledge and agree to the privacy statement provided below.
Print Full Name*
Position*
Signature*

Clear
Date*

DayMonthYear
Date
How did you hear about us?
How would you rate your experience completing this form?
Please verify that you are human*
If you would like to provide any addional information or evidence to support your application, please send us an email at agents@auscanus.edu.au.

Privacy Statement: All informaon collected, used or disclosed by Auscanus Instute of Australia (AIA) is confidenal and is protected by the Privacy Act 1988 and other relevant legislaon. AIA policy is outlined in the Informaon Privacy Policy available from our website. Informaon about Agents or students may be made available to Commonwealth and State agencies if required to provide the information by law.

if you need any further information, please contact AIA:
P: 1300 AIA EDU / +61 3 9945 8247 | E: Agents@auscanus.edu.au.

AUTHORISED BY: CEO | Last Reviewed: May 2024 | Version : 2.2
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DOCUMENTS CHECKLIST