agent enquiry form - Australian Pacific College
agent enquiry form - Australian Pacific College
agent enquiry form - Australian Pacific College
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
AGENT APPLICATION<br />
AUSTRALIAN PACIFIC COLLEGE, ENGLISH UNLIMITED &<br />
AUSTRALIAN PACIFIC TRAVEL AND TOURISM<br />
(collectively the “Provider“)<br />
If you would like the Provider to consider you or your company to act as an authorised student<br />
recruitment representative/agency, please complete this <strong>form</strong> and return it to the Provider by<br />
fax/mail/email with the relevant supporting documents for consideration. Thank you.<br />
COMPANY INFORMATION:<br />
Legal Entity: ___________________________________________________<br />
Trading Name: ________________________________________________<br />
Address: _____________________________________________________<br />
Town/City: ______________State/Country: _________Post/Zip Code:________<br />
Telephone:( )____________________ Fax:( )____________________<br />
Website:__________________________ Email: _______________________<br />
Agents whose head office is in Australia must provide:<br />
ABN: ______________________ MARN:____________________________<br />
CONTACT PERSON INFORMATION<br />
Title:_____________________________________Gender: Male Female<br />
First Name: ____________________Family Name:_____________________<br />
Position/Job Title: _______________________________________________<br />
Email Address: ________________________________________________<br />
Mobile:_____________ Telephone:( )______________Extension:________<br />
Please include country and area codes, as applicable<br />
AgentEnquiryForm_APC2013_15Apr2013_v1.6r<br />
YOUNG RABBIT PTY LTD (ABN 28 003 381 182) TRADING AS AUSTRALIAN PACIFIC COLLEGE | RTO PROVIDER 90396 | CRICOS PROVIDER 01331F<br />
AUSTRALIAN PACIFIC COLLEGE BRISBANE PTY LTD (ABN 45 120 995 780) TRADING AS AUSTRALIAN PACIFIC COLLEGE BRISBANE | RTO PROVIDER 32352 | CRICOS PROVIDER 03297J<br />
AUSTRALIAN PACIFIC TRAVEL AND TOURISM PTY LTD (ABN 13 132 743 812) TRADING AS AUSTRALIAN PACIFIC TRAVEL & TOURISM | RTO PROVIDER 91505 | CRICOS PROVIDER 03077K
OVERSEAS REPRESENTATIVE OFFICE (IF APPLICABLE)<br />
Legal Entity: ___________________________________________________<br />
Trading Name: _________________________________________________<br />
Contact person: ________________________________________________<br />
Address: _____________________________________________________<br />
Town/City: ______________State/Country: _________Post/Zip Code:_______<br />
Telephone:( )__________________ Fax:( )______________________<br />
Mobile: _________________________ Email: ________________________<br />
BANK DETAILS<br />
Bank Name: ___________________________________________________<br />
Branch Name: _________________________________________________<br />
Address: _____________________________________________________<br />
Town/City: ______________State/Country: _________Post/Zip Code: _______<br />
Account Name: _________________________________________________<br />
Account No.: _____________________________SWIFT Code: ____________<br />
I CONFIRM THAT I HAVE PROVIDED:<br />
<br />
<br />
<br />
<br />
<br />
A short profile of the agency, including directors / key person details and background including how long the<br />
agency has been in operation, main nationalities of student target market, key staff contact.<br />
A copy of Business Registration Certificate.<br />
Identification document of Director / owner (Passport, Drivers license etc.)<br />
<strong>Australian</strong> Business Number (ABN) and MARN (compulsory for Local Agents only).<br />
At least two references from <strong>Australian</strong> registered training organisations (institution name and contact details<br />
including email and telephone numbers) if you have been in operation for 6 months or more.<br />
CONFIRMATION AND UNDERTAKING<br />
I confirm that all in<strong>form</strong>ation I have provided is true and correct.<br />
I agree that the Provider may collect further in<strong>form</strong>ation about me/us and authorise my referees to disclose all relevant<br />
in<strong>form</strong>ation to the Provider.<br />
I agree to provide accurate advice to prospective students regarding the course, admission requirements, visa<br />
requirements, study options as well as assistance with applications, travel arrangements and pre-departure<br />
in<strong>form</strong>ation.<br />
Additionally I agree not to:<br />
1. engage in dishonest practices, including suggesting to overseas students that they come to Australia on a<br />
student visa with a primary purpose other than full-time study (Section 49.1)<br />
2. facilitate the enrollment of overseas students who do not comply with the conditions of their student visas<br />
(Section 49.2)<br />
3. engage in false or misleading advertising and recruitment practices (Section 49.3)<br />
4. use PRISMS to create eCoEs for other than bona fide students (Section 49.4)<br />
Name: _______________________________________________________<br />
AgentEnquiryForm_APC2013_15Apr2013_v1.6r<br />
Signature: _____________________________ Date: ___________________<br />
YOUNG RABBIT PTY LTD (ABN 28 003 381 182) TRADING AS AUSTRALIAN PACIFIC COLLEGE | RTO PROVIDER 90396 | CRICOS PROVIDER 01331F<br />
AUSTRALIAN PACIFIC COLLEGE BRISBANE PTY LTD (ABN 45 120 995 780) TRADING AS AUSTRALIAN PACIFIC COLLEGE BRISBANE | RTO PROVIDER 32352 | CRICOS PROVIDER 03297J<br />
AUSTRALIAN PACIFIC TRAVEL AND TOURISM PTY LTD (ABN 13 132 743 812) TRADING AS AUSTRALIAN PACIFIC TRAVEL & TOURISM | RTO PROVIDER 91505 | CRICOS PROVIDER 03077K
Change language