Education Agent Application Form

Please complete all sections carefully to ensure prompt processing of your application.

COLLEGE SELECTION

Please select the College(s) for which you have submitted an application: *

Key Pearson 1

Name

Position

Phone Number

International education related certifications

Key Pearson 2

Name

Position

Phone Number

International education related certifications

Does your company employ Registered Migration Agent(s) (RMA)

YesNo

If yes, please provide their MARN(s)

Does your company employ QEAC (Qualified Education Agent Counsellor)? Yes / No

YesNo

If yes, how many?

Is your company a member of any professional associations (eg. ISEAA, AAERI, ITECA, ICEF, PIER etc.)? Yes / No

YesNo

Association Name:

Membership Number:

Services

Existing Partnerships and Performance

Does your company have formal agreements with other Australian education institutions? Yes / No

YesNo

If yes, how many current, formal education agreements do you have?

In the previous 12 months, how many students have you referred to Australian education institutions under your formal education agreements?

Have you ever had an education agent agreement terminated by any institution?

YesNo

If Yes, please provide details:

Associated Entities

Does your company operate franchises?

YesNo

Please nominate the Business Names and ABNs for the franchise operations we may expect to receive applications from?

References

Please Provide 2 Referees (Contacts Of Two Other Training Providers You Represent)

Reference Pearson 1

Education Institution Name

Contact Person Name

Contact Person Position

Phone Number

How many students did you refer to this Education Institution in the previous 12 months?

Reference Pearson 2

Education Institution Name

Contact Person Name

Contact Person Position

Phone Number

How many students did you refer to this Education Institution in the previous 12 months?

Compliance

Bank Account Details (please nominate the bank account into which agent commissions will be paid)

Bank

Account Name

BSB (Australian bank accounts only)

Account Number

Swift Code

Documents to attach:

Business registration documents

MARA Certificate

QEAC Certificate

Other Doc.

ACKNOWLEDGEMENT & SIGNATURE

Name & Position

Signature Format

Pen Eraser

Sign Date

The Pacific	North Asia (including Japan and Korea)	Europe
South East Asia	Middle East	LATAM
China	UK	Other
Central Asia

Education Agent Application Form

Key Pearson 1

Key Pearson 2

Reference Pearson 1

Reference Pearson 2

Performance Monitoring Agreement

Training and Development

Quality Assurance