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Required fields are marked with asterisks (*)

Agent Application

Thank you for your interest in representing Keyano College in the international students' recruitment market. Please complete this application which will be submited to Avril Titus, International Recruitment Coordinator. Do not hesitate to email or call +1.780.791.8974 with questions that you may have.

Address

Representative (Company) Name

Website

Name of Contact Person

E-mail

Telephone number (please include international calling code)

Does your company have experience recruiting international students to Canada?

Yes

If yes, which post-secondary institutions (universities or colleges) have you recruited for in the past?

How many years of experience does your company have recruiting international students to Canada

Less than one year

1-4 years

5-9 years

10 years or more

From which countries does your company recuit international students?

Primary recruitment market(s)

Secondary recruitment market(s)

Does your company currently have staff that are Regulated Canadian Immigration Consultants (RCIC)

Yes

Reference Check

Please provide the names and contact information of two of the institutions in Canada that you have represented in the past so that we can contact them for a reference check.

Reference 1:

Name of Contact Person

Name of post-secondary institution

E-mail

Telephone number

Reference 2:

Name of Contact Person

Name of post-secondary institution

E-mail

Telephone number

Signature of signing officer

Clear

Date

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Agent Application

Reference Check