Education Agent Application

Education Agent Application
Please duly fill this form and submit along with supporting documents, including a company profile, to apply to become an authorised education agent for Blue Lotus Academy Pty Ltd trading as Blue Lotus College (BLC) for the purpose of recruiting international students to study at the BLC.

What type of business is your agency? (Select one)*

a sole proprietora partnershipan incorporated company
Name of proprietor*
Name of partners*
Registered company name*
Trading name if applicable*
Number of directors*
Name of directors*
Place of registration*
Date of registration*

DayMonthYear
Date
Expiry date*

DayMonthYear
Date
Australian Business Number ABN*
MARA no*
QEAC no*
File Upload

Please upload your organisation documents such as MARA certificate
Cancelof

How many offices representative offices do you have where are they located*
Are you a member of any agent association or professional industry body?(e.g. PIER, agent association. Please provide a copy of the membership certificate if selected "YES")*

YesNo

Upload the copy of the membership certificates.

Cancelof
Which courses are your clients most interested in? (Please tick relevant boxes)*

General EnglishAcademic EnglishUniversity FoundationVocational EducationUndergraduatePostgraduateOther

Rows	Name of the industry body (eg Education Agent Association)	Years of membership
1
2
3

List the Australian education Institutions you currently represent:*

Rows	Name of Institution	How many years have you represented this Institution?	Total number of students recruited to this Institution?
1
2
3
4
5
6

List the education Institutions you currently represent for countries other than Australia:

Rows	Name of Institution	How many years have you represented this Institution?	Total number of students recruited to this Institution?
1
2
3
4

If appointed as an Agent for BLC, how many students will you aim to recruit in the first year?*
State briefly how you plan to recruit students to the courses offered by BLC You may attach a separate document your marketing plan*
Do you charge (or intend to charge) students / applicants any fee or commission for processing their application?*

YesNo
How many years of experience you have in Australian education Sector?*

Please provide the name of three referees who may be contacted if your company is selected. At least one referee must be from an Australian education institute.

Note: For Reference 2 field's, please fill all the fields for Reference 1.
Reference 1
Full Name*
Address*
Company*
Position*
Phone*
Format: (000) 000-0000.
Email*
example@example.com
Reference 2
Full Name*
Address*
Company*
Position*
Phone*
Format: (000) 000-0000.
Email*
example@example.com
Reference 3
Name
Address
Company
Position
Phone
Format: (000) 000-0000.
Email
example@example.com

I confirm that the information provided on this application is true and accurate to the best of my knowledge. I also authorise Blue Lotus College to contact my referees. I acknowledge that approval of my application is conditional on my company signing an Agent Agreement with Blue Lotus College in accordance with National Code 2018 and VET Quality Framework (VQF) including standards for NVR.
Authorised Signature*
Date*

DayMonthYear
Date
Name of the Officer*
Position*

Confirm that you have filled the Education Agent Application Form and provided evidence as filled in the form.*

Application form completed and signedEvidence of business registration attachedCompleted and signed Agent Agreement attached
RTO CODE: 45392 I CRICOS CODE: 03790G I ABN: 12620656671
Should be Empty:

Reference 1