VIA Agent Application Form (March 2026)

VIA Agent Application Form
Section 1 – Education Agent Details
Legal entity name of the Education Agent:*
Trading / business name(s):*
Name of owner(s) / principal(s):*
Is the Education Agent an Australian business?*

YesNo
If yes, ABN:*
Head office address:*
Head office address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Postal address (if different):*
Postal address (if different):*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Does the Education Agent operate any other branch or office in Australia or overseas?*

YesNo
If yes, list all branch / office locations:*
Main contact number:*
Please enter a valid phone number.Format: 0000 000 000.
Main contact email:*
example@example.com
Website (if any):*
Section 2 – Main Contact Person
Main Contact Person for the Education Agent
Name:*

Given NameFamily Name
Position:*
Contact number:*
Format: 0000 000 000.
Email:*
example@example.com
Section 3 – Education Agent Operations
Year business commenced:*
How many years has the Education Agent been involved in student recruitment?*
Which countries does the Education Agent mainly recruit students from?*
Total number of staff (including branch / overseas office staff):*
Approximate number of students recruited per year:*
Which other education providers does the Education Agent currently represent?*
Ownership / control disclosure
Does the Education Agent, or any owner, director, manager, related entity or associate, have any direct or indirect ownership, control, beneficial interest, shareholding, directorship, management role or other material commercial interest in VIA Education or any related entity of VIA Education?*

YesNo
If yes, provide details:*
Conflict of interest disclosure
Does the Education Agent have any actual, potential or perceived conflict of interest relevant to the services it would provide on behalf of VIA Education?*

YesNo
If yes, provide details:*
Section 4 – Migration Agent Information
Does the Education Agent employ, engage or work with any registered migration agent?*

YesNo
If yes, provide the name and MARN of the registered migration agent:*
Section 5 – Services Provided
What student-related services does the Education Agent provide?*

Accommodation placementOSHC arrangementsAirport pickupVisa-related administrative assistanceInternship / placement assistanceOther
Section 6 – Memberships / Associations
Is the Education Agent a member of any education agent or international education association in Australia or overseas?*

YesNo
If yes, provide details and attach evidence:*
Evidence:*

Cancelof
Section 7 – Student Counsellors / Recruitment Staff

Details of student counsellors / staff involved in recruitment*

Rows	Staff name	Position / role	Office location	Years of experience	Qualifications / relevant training	Contact details
1.
2.
3.
4.
5.
6.

Section 8 – History / Due Diligence
Has the Education Agent ever had an agreement suspended, cancelled or terminated by any education provider?*

YesNo
If yes, provide details:*
Section 9 – Regulatory / compliance history
Has the Education Agent, or any owner, director, manager or student counsellor, been subject to any regulatory action, sanctions, substantiated complaints, or findings relating to student recruitment, migration advice, misleading conduct or education agent activities?*

YesNo
If yes, provide details:*
Section 10 – Referees
Please provide details of two referees from education providers the Education Agent currently represents in Australia.
Referee 1
Provider name:*
Contact person:*
Position:*
Phone:*
Format: 0000 000 000.
Email:*
example@example.com
Referee 2
Provider name:*
Contact person:*
Position:*
Phone:*
Format: 0000 000 000.
Email:*
example@example.com
Section 11 – Supporting Documents
Please attach the following documents, where applicable:
Business registration / company registration documents*

Cancelof
ABN registration (if applicable)

Cancelof
Business Profile*

Cancelof
Staff qualifications / training evidence*

Cancelof
Migration agent registration evidence (if applicable)

Cancelof
Membership/ association evidence including QEAC (if applicable)

Cancelof
Other

Cancelof
Section 12 – Declaration
Education Agent Declaration
I am interested in representing VIA Education as an Education Agent and commit to doing so honestly, ethically and professionally.
I declare that the information provided in this application and in the attached documents is true, correct and complete.
I acknowledge that VIA Education may only pay Education Agent Commission where permitted by law and the written agreement, and that commission may not be payable in certain onshore student transfer cases.
I agree to promptly notify VIA Education of any material change to the information provided in this application, including changes to legal entity details, ownership, control, branch locations, migration agent status, key staff, or any conflict of interest relevant to the services provided on behalf of VIA Education.
Name:*
Position:*
Signature:*
Date:*

DayMonthYear
Date
Should be Empty:

VIA Agent Application Form

Section 1 – Education Agent Details

Section 2 – Main Contact Person

Main Contact Person for the Education Agent

Section 3 – Education Agent Operations

Ownership / control disclosure

Conflict of interest disclosure

Section 4 – Migration Agent Information

Section 5 – Services Provided

Section 6 – Memberships / Associations

Section 7 – Student Counsellors / Recruitment Staff

Section 8 – History / Due Diligence

Section 9 – Regulatory / compliance history

Section 10 – Referees

Referee 1

Referee 2

Section 11 – Supporting Documents

Section 12 – Declaration

Education Agent Declaration