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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:

  1. Your company’s full contact details
  2. Contact details for two institutional references (One must be from a Canadian Education Institute)
  3. 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.