Become Partner

Company Name

Trading Name

Phone

Address

Postcode

Website

Business Activities

No. of Offices

Staff Count

Locations

Years Established

Name

Position

Qualification

Membership

Migration Agent

MARN Name

MARN Email

MARN Number

Target Markets

Marketing Strategy

Do you charge students fee?

Yes/No

Service Name

Fee Amount

Institution 1 Name

Contact Person

Position

Phone Number

Institution Name

Contact Person

Position

Phone Number

Print Name

In signing this agreement, you declare that

I have read and understood the extract from the ESOS Act 2000 Obligations of Agents. The answers and details provided in this application are true, accurate and complete. Le Pont International College is authorised to contact the referees listed to collect information about my conduct and services. I acknowledge and agree to the privacy statement provided below.

Position

Date

Signature

Please attach the following documents to support your application:

Copy of business registration details A profile outlining your agency’s services and credentials A proposed marketing plan of how you intend to recruit students for Le Pont International College (if applicable) A list of all sub-agents including the agency name, agency website, details of the term of their appointment, contact name and contact information (if applicable)