Agent Application
Name
of
Agency:
Owner/CEO:
Date
founded:
Address:
Tel:
Email
Web:
Number
of
full
time
employees:
Number
of
full
time
employees
educated
in
the
US/UK/AUSTRALIA:
Number
of
full
time
employees
that
hold
Certificates/Designations
of
training
in
Overseas Education:
Membership
in
Professional
Organizations:
Please
list
only
memberships
of
full
membership
and
or
certification
(NAFSA,
AIRC,
AACRAO
or
local
Counseling
Organization).
Please
provide
web
site
for
all
org’s.
1)
Web:
2)
Web:
3)
Web:
4)
Web:
1
Participation
in
Professional
Conferences
and
Training
Seminars
Please
list
the
Professional
Development
taken
on
by
your
or
your
staff:
Number
of
Undergraduate
students
placed
in
US
Universities:
Does
your
agency
currently
have
agreements
with
US
Universities? Yes/No
Please
list
if
permitted
Name
of
Univ.
1)
2)
3)
4)
Contact
person:
Tel:
Contact
person:
Tel:
Contact
person:
Tel:
Contact
person:
Tel:
E:
E:
E:
E:
2