OICC 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?
Which of the following destinations do you plan to recruit for?

Other
If 'Other' selected please specify:
Which are the top three destinations for your students?
Do you have any past, pending or threatened litigation, arbitration, administrative actions or other disputes?
If 'Yes' please specify:
Which other UK / USA / Canada / Australia schools or institutions do you represent?
How many students do you currently send to the UK/USA/Canada/Australia for the following courses per year?
Career Colleges
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
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
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 the UK/USA/Canada/Australia for the following courses per year?

Company Operations

Business References