Expression of Interest Form
Please provide your company information
Company name:
Contact person:
Address:
City:
Country:
Please Select...
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia & Herzegowina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde Islands
Cayman Islands
Central African Republic
Chad
Chile
China (PRC)
Christmas Island
Cocos-Keeling Islands
Colombia
Comoros
Congo
Congo, The Democratic Republic of The
Cook Islands
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji Islands
Finland
France
French Guiana
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea (PRP)
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea (North)
Korea (South)
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtein
Lithuania
Luxembourg
Macau
Macedonia, (former Yugoslav Rep.)
Madagascar
Malawi
Malaysia
Maldives
Mali Republic
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte Island
Mexico
Micronesia, (Federal States of)
Moldova, Republic of
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Marianas Islands (Saipan, Rota & Tinian)
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Réunion Island
Romania
Russia
Rwanda
Samoa Western
San Marino
São Tomé and Principe
Saudi Arabia
Scotland
Senegal
Seychelles Islands
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
St. Helena
St. Kitts/Nevis
St. Lucia
St. Pierre & Miquelon
St. Vincent & Grenadines
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga Islands
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna Islands
Yemen
Yugoslavia
Zambia
Zimbabwe
Other - Not Listed
Postcode:
Telephone (inc area code):
Fax (inc area code):
Email:
URL:
Has your agency previously recruited students for Edith Cowan University ?
Please Select...
No
Yes
Which country/countries will you be recruiting students from:
How long has your company operated as an education agency?
Please Select...
0-3 years
3-5 years
5-10 years
10+ years
Please describe any previous experience you have had in the recuitment of international students:
Is the recruitment of international students the main component of your business ?
Please Select...
No
Yes
Do you expect to authorise any sub-agents to work on your behalf?
Please Select...
No
Yes
*If so, please name them:
Is your business registered with any agency (ie. government department) in the country from which you plan to recruit international students ?
Please Select...
No
Yes
Please advise names of any other institutions you currently represent:
Is your business conducted from an office/shop ?
Please Select...
No
Yes
*If not, please describe nature of premises:
Have you or any of your staff ever visited australia ?
Please Select...
No
Yes
Have you or any of your staff ever visited perth ?
Please Select...
No
Yes
Have you or any of your staff ever visited ECU ?
Please Select...
No
Yes
Please supply a plan outlining proposed international student recruitment activities, including target numbers you believe you can recruit for Edith Cowan University overthe next two years:
Please advise of any charges that are made directly to students for applications/counselling/administration:
Please provide two references - you must provide the contact person, company, address, phone number and where applicable, email for two educational institutions that you currently act as an agent for.
Reference 1
Name of Institution:
Contact Person:
Email Address:
Telephone Number:
Reference 2
Name of Institution:
Contact Person:
Email Address:
Telephone Number:
Any other information ?