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AGENCY APPLICATION FORM (Summer School Programme)

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

Target Market/ Country for Recruitment

Expected Number of Student You Could Recruit for us

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.