Agent Application Form - Montford International College

Company Details

Company Name *

Business Name / Trading Name

Country of Registration *

Year Established *

ABN / Registration No *

ACN (Optional)

Directors Name

CEO Name

* At least one of Directors Name or CEO Name must be provided

Staff Professional Memberships

Staff Name	Membership Body	Membership No

Head Office Details

Address Line 1 *

Address Line 2

City *

State/Province *

Post Code

Country *

Office Email *

Office Phone *

Web Address (Optional)

Contact Person

Contact Person Name *

Position *

Contact Email *

Contact Phone *

Business Background

Years in Business as Educational Agent *

Australian Educational Institutions Represented:

Institution Name	Contact Person	Email/Phone

Services Provided (tick all that apply):

Student counselling

Pre-departure briefing

Visa application assistance

College application assistance

Overseas health cover

Parent follow-up

Fee collection

English testing

Do you use sub-agents or other people not employed directly by you?

Yes

No

Are you prepared to provide sub-agent details to MIC?

Yes

No

ESOS Requirements Understanding

Do staff have knowledge of international education system and national code of practice?

Yes

No

Do staff have knowledge of Agent Code of Ethics?

Yes

No

Do you ensure students have primary purpose of studying?

Yes

No

Do you understand not to make guarantees about residential status?

Yes

No

Are you prepared to comply with all MIC requirements?

Yes

No

Are you prepared to only use MIC-supplied material?

Yes

No

Educational Institution Referees

Provide two referees from educational institutions:

Referee 1 - Name *

Referee 1 - Email *

Referee 1 - Contact Number *

Referee 2 - Name *

Referee 2 - Email *

Referee 2 - Contact Number *

Required Documents

Please attach copies of the following documents:

Company registration certificate
Business registration certificate
Company profile/brochure
Any relevant professional certifications

Company Registration Certificate *

Business Registration Certificate

Company Profile/Brochure

Declaration and Signature

Declaration

I declare that the information provided in this application is true and correct. I understand that any false or misleading information may result in the rejection of this application or termination of any agreement entered into. I agree to comply with all relevant Australian laws, regulations, and codes of practice relating to international education and training.

I acknowledge that I have read and understood the above.

📝 Signature *

Agent Representative Signature *:

Date *