Personal Information Company Name: Key Contact (Ms/Mr/Dr) Current Job Title Office Address City Mobile Number Email Address Company Details When was your compnay established Description of your core business Have you refeered 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 refered 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 Existing number of staff Details and backgrounds of key staff in your organization Key Staff no. 1 Title Family Name First Name Position Phone No. E-mail Number of years with company Background, qualification and previous experience: Key Staff no. 2 Title Family Name First Name Position Phone No. E-mail Number of years with company Background, qualification and previous experience: Key Staff no. 3 Title Family Name First Name Position Phone No. E-mail Number of years with company Background, qualification and previous experience: Business Experience and Financials Details Is the company in a sound financial position? (Yes/No) Are there any judgements or orders against the company or its principals, or 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? References Please provide two references before your application will be considered Name Company Position Address Telephone E-mail Website Please provide two references before your application will be considered Name Company Position Address Telephone E-mail Website
