Agent Application

Company Details

Please provide the registered company name (as stated in the business certificate)*
Trading Name (if different from registered company name)
Website URL/link*
Head office address*
City*
State/Province
Postcode*
Country*

Company Director Details (for contract purposes)

Title* —Please choose an option—Mr.Mrs.Miss.Other.
First name*
Last name*
Telephone number*
Email address*

Key Contact (for Account Management)

Title* —Please choose an option—Mr.Mrs.Miss.Other.
First name*
Last name*
Telephone number*
Email address*
Job title*

Finance Contact Details (for finance/commission-related communication purposes)

Title* —Please choose an option—Mr.Mrs.Miss.Other.
First name*
Last name*
Telephone number*
Email address*
Job title*

Partner Portal Admin Details

Partner Portal is the tool our partners use for managing student applications. Portal Admin is the person in your organisation responsible for Partner Portal user administration. Portal Admin has the highest access to Partner Portal and can grant access to others within your organisation.

Title* —Please choose an option—Mr.Mrs.Miss.Other.
First name*
Last name*
Email address*
Telephone number*
Job title*

Company Overview

Students sent to the UK per year*
Countries where organisation recruits students from*
Year established*
Branches/offices in other locations*
Does or has worked as a sub-agent of a CEG Agent*
Are you an existing agent of CEG?* If yes, please provide your EMP number
Name your key university partners in the UK
Counsellors employed*
How did you hear about Cambridge Education Group*
Why do you want to work with Cambridge Education Group*

Referees

First referee name*
First referee company name*
First referee job title*
First referee email*
First referee telephone*

Second referee name
Second referee company name
Second referee job title
Second referee email
Second referee telephone