Potential Agent Application Form

In order to assist AINiT in the selection of Agents to represent them, please complete the following steps and submit the application:

Note: Please fill out all the manadatory fields which is marked by *

Personal Information
Company Details
Description of Potential Market
Business Experience and Financials Details
Declaration

Personal Information *

(Note: Fields are mandatory which marks with *)
Company Name:* Key Contact (Ms/Mr/Dr) * Current Job Title *
Office Address * City * Mobile Number *
Email Address * Website

Company Details

When was your compnay established *Description of your core business
Have you referred any student overseas in last 12 months? (Yes/No), If Yes, please details: Do you have experience in Career Counselling, If Yes, please provide details

Description of Potential Market

Projected number of students to be referred to AINiT in next 2 years for the following countries
Number of students for Australia *Number of students for New Zealand Number of students for Canada
Number of students for US Number of students for UK Number of students for Malaysia
Number of students for Turkey Number of students for Germany Number of students for China

Business Experience and Financials Details

Is the company in a sound financial position? (Yes/No)Yes No Are there any judgements or orders against the company or its principals, or Applications for its winding up, dissolution, liquidation or cessation of business? Yes No
If yes, in relation to any of these, please supply details Have you ever been involved in a business, if yes, please provide details
Have you ever been involved in a representative business, if yes, please provide details Sales experience (if any, years)
What is your gross income (investments included) Why do you want to become an AINiT VERIFIED AGENT? *

Declaration

I do here by declare that the above information which I provided is true and correct to the best of my knowledge.

Declared by *
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