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AGENCY APPLICATION FORM

A. Company Details

Company Name

Company Registration Number

Date of Establishment

Company Address

Postcode

Office Contact Number

Company Email Address

Submit Company Registration Cert below (PDF/ JPEG)

Submit Company Profile below (PDF/ JPEG)

B. Company Owner Details

Name (Mr/ Ms)

Position

Contact Details

Email Address

C. Account Details

Company Bank Account Name

Bank Name & Address

Bank Account Number

Bank Swift Code

If the Bank Account Name is different from the Agency Name, please submit an Authorisation Letter issued and signed by the Company Owner/ Director. Otherwise, your commission claim will not be processed (PDF/ JPEG).

D. Additional Information

Number of Years in Operation

Number of Office

Number of Staff

Number of Student Recruited in The Past 1 Year

Target Market/ Country for Recruitment

Expected Number of Student You Could Recruit for Us in a year

From which channel you first learned about us

E. Declaration

I, on behalf of my agency, declare that the information provided above are true and complete, and I fully understand that King Henry VIII College reserves the right to revoke my agency's application/ appointment should the School finds false or incomplete information in this application form, of which will directly affecting my legibility of making commission claim.