Agent Registration Form

Company Name*:

Date Established:

Address Line 1*:

Address Line 2:

Town*:

County/State/Province:

Post Code*:

Country*:

Telephone:

Company Email*:

Website*:

Do you have other locations? (Please specify)*:

Family Name*:

First Name*:

Job Title*:

Email*:

How did you hear about us?:

Main regions/countries covered*:

Current member organisations (eg British Council)*:

.

Which fairs did your agency attend in the last 4 years?

.

Do you work with other UK schools?: yes no

If yes, Which ones?

Which clients do you usually represent?

 Individuals Groups Business/Professionals

What ages are your clients?

 <10 years 11-17 years 18-35 years 35-50 years >50 years

What length of study is most requested?:

How many clients are expected to study in the UK this year?:

Which courses are your clients interested in?

 General English Exam Preparation Diploma Courses Business English

Other courses of interest:

Reference 1 (Company, Contact Name, Email and Phone)*:

Reference 2 (Company, Contact Name, Email and Phone)*:

Comments:

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