:: EDUCATION AGENT APPLICATION FORM

EDUCATION AGENT DETAILS

Legal Business Name

Trading Name

Country of Company Registration

Date of Establishment

ABN

ACN

Registered Company Address

Contact Person Name and Position

Email Address

Phone No.

Website URL

SECTION 1: COMPANY DESCRIPTION

Please provide a description of your company (including number of MARA/ QEAC qualified counsellors and registration numbers) and attach an official copy of your company / business profile and MARA/QEAC certificates (if available)

SECTION 2: KEY PERSONNEL

Please provide an overview of the key personnel within your company (attach additional pages as required)

Name

Position

SECTION 3: GENERAL

What services do you provide or intend to provide to our prospective students, and how will you support them? (If service fees are charged, please indicate the amount)

What are your main recruitment markets or regions?

Do you work with sub-agents?

Yes No

Agency Performance and Compliance

How many Australian education institutions are you currently representing?

How many students have you referred to Australian educational institutions in the past 2 years?

A conflict of interest occurs when an education agent has a personal, financial, or business interest that could influence, or be perceived to influence, their ability to act honestly, impartially, and in the best interests of students and the RTO.

Do you have any actual, potential, or perceived conflict of interest that may influence, or be seen to influence, your recruitment practices or representations on behalf of the RTO (including financial interests, relationships with other providers, or incentive arrangements)? If yes, please provide details.

Do you regularly monitor the Department of Home Affairs (DHA) website https://immi.homeaffairs.gov.au/ and the Department of Education?

Yes No

Are you willing to comply with the requirements of ACTB regarding advertising, course materials and application procedures, and provide accurate information to students?

Yes No

Are you prepared to use the marketing materials provided by ACTB to promote our courses?

Yes No

Additional Information

Please provide any other information that you think will support your application.

SECTION 4: REFEREES -Please Provide 2 Referees (Contacts Of Two Other Training Providers You Represent) Referee 1

Referee 1

Education Provider

Name

Address

Email Address

Phone No

Referee 2

Education Provider

Name

Address

Email Address

Phone No

SECTION 5: CAMPUS SELECTION

Please select the campus(es) for which you have submitted an application: NorthwestBrittsACTBDITMenzies

SECTION 6: PRIVACY STATEMENT

Our approved Education Agents agree to their business and contact information to be:

Published on our website;
Recorded in PRISMS – including their name, business e-mail address, phone number and address;
Shared with and accessed by the Australian Government Department of Employment and Workplace Relations, the Department of Home Affairs, and other Commonwealth agencies through PRISMS;
Used to administer or monitor compliance with the Commonwealth legislation such as the ESOS Act 2000 and the Migration Act 1958; and
Disclosed to and by the Australian Government Department of Employment and Workplace Relations to other Australian Government entities such as ASQA, education institutions and publicly.

SECTION 7: ACKNOWLEDGEMENT

One of the key requirements of the ESOS Act is that all providers on the Commonwealth Register of Institutions and Courses for Overseas Students (CRICOS) must maintain a list of all the provider’s agents, and publish that list on its website. Australian College of Technology and Business will be listing the names of education agents who recruit international students in the Department of Employment and Workplace Relations’ (DEWR) Provider Registration and International Students Management System (PRISMS). I acknowledge that:

The information provided in this form is true and accurate;
I have never engaged in dishonest or unethical practices;
My details can be published on the ACTB website and on PRISMS;
Responsible steps, if required, can be taken to avoid conflicts of interest with my duties as an Education Agent;
I/we shall provide the requisite evidence(s), if any are required by ACTB;
I confirm that I have read, understood, and agree to comply with all applicable regulations, legislation, and ethical obligations relevant to my role as an Education Agent.

Name & Position

Signature

Pen Eraser

Education Agent Application Form

Agency Performance and Compliance

Additional Information

Referee 1

Referee 2