Application for Inforum agent representative

Agent details
* Required
Company name*
Trading name*
ABN or ACN (if Australian company)
Business website
Phone number*
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Contact person 1*
Email*
Contact person 2
Email
Branches
Services for students*
Do you charge fees from students?*
- Yes
- No
If yes, how much?
Institutions represented on the Gold Coast*
Countries where you send students to*
Memberships of associations*
How long has the company been operating?*
Number of staff in study abroad section?*
Company profile and supporting documents
Drop files here or
Max. file size: 29 MB.
Referee details
Please provide two referees.
[Referee 1] Company name
Contact person
Position
Address
Phone number
Email
[Referee 2] Company name
Contact person
Position
Phone number
Email
Phone
This field is for validation purposes and should be left unchanged.

Agent details