New Agent Application Form

Please fill out the application below. Due to the high volume of agent applications we receive, we will only respond if we are looking to expand our agent network in your market(s). If you do not hear from us, your application will be kept on file. If our marketing plans change , your application will be reviewed again and we will contact you. Thank you again for your interest in working with us.

Agency Details

Name of the contact person(Required)
Address(Required)
Company's Owners Name
Is your company registered to operate as an education agency, business or organization?(Required)
Do you currently work with any Canadian colleges or universities?(Required)
Which type of business insurance do you currently have?(Required)

Does your agency provide any immigration counselling?(Required)
The Agent acknowledges that anyone providing immigration/citizenship advice or representation for a fee or other considerations, be it directly or indirectly, must be an authorized representative in accordance with the Immigration and Refugee Protection Act (IRPA) and the Citizenship Act in Canada, Bill C-35.(Required)
Do you have any dealings with the local Canadian Embassy/High Commission?(Required)

Service Information

Do you provide the following services to applicants:(Required)
Do you provide the following services to the institutions you currently represent?(Required)

Marketing and promotion information

Accepted file types: jpg, gif, docx, doc, pdf, Max. file size: 1 GB.
Max. file size: 1 GB.
Max. file size: 1 GB.

References

At lease one reference MUST be a Canadian post-secondary institution.
Reference 1: Address(Required)
Reference 1: Contact Name(Required)
Reference 2: Address(Required)
Reference 2: Contact Name(Required)

Declaration

I confirm that the information on the form is complete and accurate and that all essential information has been included. I agree that Loyalist College can process my information for my application and internal market research.(Required)