Agent Application Form

Thank you for your interest in representing Conestoga College for the recruitment of International Students.

Before completing the attached application to become a representative of the College, you will need:

Your company’s full contact details
Contact details for two institutional references (One must be from a Canadian Education Institute)
A company profile (in Microsoft Word or PDF format only) attached to this application

Note: Fields represented by a * must be completed

Agent Information
Company Details
*Company name:**
*Contact name:**
*No. of students sent to Canada in the last 12 months:**
*Recruitment areas:**
*No. of staff in office for students:**
Main Office Contact Details
*Phone number:**
*E-Mail:**
Facsimile:
Website:
Company Address
Street:
Suburb:
City:
State/Province/Region:
Postcode/Area code:
Country:
Business Profile
*Business Profile:**
References Information
Reference 1
*Contact Name:**
*Contact Position:**
*Business Email:** (ie: @gmail, @yahoo, @hotmail not accepted)
*Phone Number:**
Fax Number:
Website:
*Address:**
Reference 2
*Contact Name:**
Contact Position:
*Business Email:** (ie: @gmail, @yahoo, @hotmail not accepted)
*Phone Number:**
Fax Number:
Website:
*Address:**
Declaration
1.I declare that the information contained in this application and all supporting documentation is true and correct. 2. I agree.