AGENT APPLICATION FORM

For consideration to be appointed as certified agent of Australian Institute of Engineering to assist the
college in the selection of agents, please complete this form and return it by email to:
Note: completion of this application form will not make you an agent of Australian Institute of Engineering
but will enable the college to consider appointing you as such.

Your Name

Company/Business Name: (required)

Trading Name (if different)

Company Registration Number / Australian Business Number (ABN): (required)

Company/Business Street Address:

Company/Business Postal Address:

Name of Registered Owner/Principal:

Name of Chief Executive Officer (if different):

Phone: (required)

Mobile: (required)

Email: (required)

Company information:

How long has your company been in existence?

Branches:

Description of your major business activities:

Sub Agents employed (if applicable attach full details):

Services provided to students:

Number of students sent abroad per year:

Countries students are sent from:

Institutions / Colleges currently representing:

Services provided to institutions:

Please explain your plans for recruiting students to Australian Institute of Engineering:

What professional associations are you a member of?

Number of students you estimate to recruit for Australian Institute of Engineering over the next 12 months:

Have you ever had a previous education agent agreement cancelled by a RTO?
YesNo

Please provide us with a sample or your organisation’s promotional materials and advertisements (English
and any other applicable languages)

– attach the documents (if available)

Please attach the following to your application:

Business Registration Certificate

Copy of your company profile

Samples of marketing material distributed by your agency

Copy of Register of company

Copy of register of directors

Copies of key directors and employees qualifications

PLEASE PROVIDE CONTACT DETAILS OF TWO REFEREES (Preferably Australian education providers or alternatively, business referees):

*Please Note these referees will be contacted.

Reference 1

Name:

Position:

Organisation:

Street Address:

Postal Address:

Phone:

Email:

Reference 2

Name:

Position:

Organisation:

Street Address:

Postal Address:

Phone:

Email:

PLEASE READ THE FOLLOWING CAREFULLY:

• I/ We understand that submitting this ‘Agent Application Form’ to Australian Institute of
Engineering, does not grant or guarantee registration as an agent for recruiting domestics and
international students. Australian Institute of Engineering reserves the right to cease all business
dealings with me / us if we mislead prospective students or misrepresent Australian Institute of
Engineering as authorised agents or representatives of Australian Institute of Engineering.
• I/We prepared to enter into an agreement with Australian Institute of Engineering
• All the information provided above is true and accurate.
• I am interested in representing Australian Institute of Engineering as an education agent and I agree
to do so in an honest and professional manner as per the National Code of Practice for Registration
Authorities and Providers of Education and Training to Overseas Students (The National Code) and
the ESOS Act 2000 https://internationaleducation.gov.au/Regulatory-Information/EducationServices-for-Overseas-Students-ESOS-Legislative-Framework/ESOSRegulations/Pages/default.aspx