Agent Application Form

Name*

TitleFirst NameLast Name
Company name*
Job Title*
Phone Number*

Country dialling codePhone Number
Email address*
example@example.com
Finance Email address (for invoicing)*
example@example.com
Company Director Details

(for contact purposes, leave blank if same as above)
Name

TitleFirst NameLast Name
Job Title
Phone Number

Country dialling codePhone Number
Email
example@example.com
Company Details
Name of Company*
Trading Name (if different)*
Website address (if have)*
Please enter full address https://...
Head Office Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Company Overview
How many students do you currently send abroad per year?*
USACanadaUnited KingdomAustralia
If 'Other' selected please specify:
What are the nationalities of students you have sold to within the past 5 years?*
Do you have any past, pending or threatened litigation, arbitration, administrative actions or other disputes? *
If 'Yes' please specify:
Which other Canada / USA schools or institutions do you represent?*
How many students do you currently send to Canada/the USA for the following courses per year?
College / Boarding School*
Creative course*
University Preparation*
Adult English Language*
Junior English Language*
Direct entry to university*
Company Operations
What year was your company established?*
Do you have any branch offices? If yes, please list locations and addresses*
How many counsellors do you employ?*
Are you ICEF Registered Agency? If Yes, what is IAS ID number?*
How did you hear about Oxford International?*
Why do you want to work with Oxford International?*
Business References

Our reputation is our guarantee and therefore it is a requirement that we obtain some background information about those agencies wishing to represent us. We would appreciate it if you could provide us with the details of two Institutions you have sent students to who we may contact for a reference.
First Referee Name*

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

Country dialling codePhone Number
First Referee Company website*
Second Referee Name*

TitleFirst NameLast Name
Second Referee Company Name*
Second Referee Email*
example@example.com
North America
Second Referee Phone Number*

Country dialling codePhone Number
Second Referee Company website*
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Should be Empty:

Company Director Details

Company Details

Company Overview

How many students do you currently send to Canada/the USA for the following courses per year?

Company Operations

Business References

North America