Expression of interest – Education Agent

Application must be accompanied by Copy of business registration Evidence of EATC

Agent Details

Company Legal Name
Date of Registration(Company)
Trading as
Business Address
ABN
Year of registration
Owner's Name
Owner's Contact details
Manager's Name
Manager's Contact Details
Phone
Mobile No.
Website
Number of staffs

Number of students referred to Australian education institutions over the past year:

High School
ELICOS:
TAFE
Undergraduate
Post Graduate

Please list any other institutes you represent in Australia
Is your company involved in any other activities?	Yes No
Are you accredited to act as an education agent in your country?	Yes No
If Yes, please provide details:
What is the most suitable time of the year to conduct a marketing trip to your region or a visit to your office to recruitstudents
Do you assist students while in Australia	Yes No
If yes, please select	through an office in Australia Through an overseas office

References

Referee 1

Company Name
Contact Person
Phone
Position
Address
Email

Referee 2

Company Name
Contact Person
Phone
Position
Address
Email

Agent Bank Details

Please complete your bank account details below into which you wish the commission payments to be made. If there is any change in Bank Account details, please advise us in advance.

Financial Institution Name
Financial Institution Name
Bank Address
Name of Bank Account
SWIFT Code
BSB Code
Account Number

Declaration

Please sign the declaration below:

I understand that Institute of Business and Management (Victoria) is not under any obligation to accept my application to act as an agent to recruit students on their behalf. understand that if my application to become an agent of Institute of Business and Management (Victoria) is successful, I will be required to enter into and abide by a formal agency agreement.
I confirm that I have all the necessary registrations, accreditations and permissions to act as an education agent in all the territories which I have nominated, and understand that I must notify the institute if any changes occur in the registration status of my agency.
I have read, understand and agree to abide by the terms and conditions of the institute’s privacy policy.
I consent to Institute of Business and Management (Victoria) to contact any of the referees I have nominated.
I undertake that the above information provided in this application is a true and accurate record as to the operation of the educational agency I represent.

By returning this application to Institute of Business and Management (Victoria), I agree to abide by the terms and conditions in the mentioned declaration.

Address & Contact for notices:
60 Belfast Street, Broadmeadows, VIC, 3047.
Phone: +61 3 94783163
Email: info@ibm.vic.edu.au
Website: https://ibm.vic.edu.au

Name of the officer
Financial Institution Name
Bank Address
Name of Bank Account
Signature of Officer/ Agent:
Date

-For Agents

Expression of interest – Education Agent

Agent Details

Number of students referred to Australian education institutions over the past year:

References

Referee 1

Referee 2

Agent Bank Details

Please complete your bank account details below into which you wish the commission payments to be made. If there is any change in Bank Account details, please advise us in advance.

Declaration

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