Agent Application Form

Please complete all questions by typing in the grey areas, and where needed attach documentation with your application.

Name of Agency:

Name of Agency Owner:

Address of Agency:

Country:

Post/Zip Code:

Tel No.:

Fax No.:

!mail Address:

"e#site Address:

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$.

Please send confirmation of owners%ip. Attached? Select...

&.

'o you %a(e a licence to operate) Select... (if yes please send copy for confirmation)

*.

Please send Confirmation t%at you %a(e full operational offices. Attached? Select...

+.

,ow many student -isas %a(e you %elped students to process)

..

,ow many -isa applications were accepted) /e0ected)

1.

"%at is your -isa success rate)

2.

,ow do you monitor academic suita#ility of students)

3.

,ow do you esta#lis% a student4s 5true intent to study4)

6.

,ow do you monitor student4s nglis% 7anguage le(els)

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$8.

'o you inter(iew all students and record t%eir responses) Select...

$$.

,ow do you monitor t%e financial (ia#ility of t%e student)

$&.

,ow do you mar9et your ser(ices) :end examples of mar9eting material.

$*.

,ow many applications %a(e you forwarded to ot%er institutions) Please list #y Country.

$+.

"%at is your percentage success rate of applications to enrolments) ;i(e an example of a <= institution.

$..

'o you 9eep in touc% wit% students once t%ey %a(e enrolled) Select...

$1.

,ow do you monitor %ow your students are progressing academically)

$2.

'o students %a(e an opportunity to gi(e feed#ac9 of experiences in relation to information gi(en to t%em pre enrolment) Select...

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$3.

,ow do you monitor t%e et%ics and performance of t%e institutions you represent)

$6.

,ow often do you (isit t%e institutions you represent)

&8.

,ow do you 9eep up to date wit% current -isa regulations)

&$.

'o you c%arge t%e student for your ser(ices) Select... >f so? %ow muc%)

Please supply two references of institutions you %a(e represented. If you are a new agent this will not be necessary however we will require this once you have started to represent institutions.

$st /eference (Name, Institution & Email address):

&nd /eference (Name, Institution & Email address):

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Membership Fees
@&88 ! Application Fee and First Aear :u#scription Fee. (covers all offices ithin a!ency) @2. ! :u#scription Fee for eac% /egistered Office for eac% su#seBuent year.
(this includes ne ly issued secure certificates)

Notes: ". &. (. ,. #ayment to $e made upon application usin! the $an% account details $elo . Applications will not #e considered until payment %as #een made and cleared. 'ou ill $e notified of the result of your application ithin ( ee%s of receipt. )ependent upon referees. If you are unsuccessful your application fee ill $e refunded minus an administrative char!e of *"++. -n successful mem$ership of .ISAN you ill receive: o o 7. Secure #rinted Non/0ransfera$le 1em$ership 2ertificate #er 3e!istered -ffice )etails of the .ISAN 4o!o56ite mar% for your o n promotional use

'ou ill $e notified throu!h the e$site and e/mail, of other mem$ership $enefits, ne sletters, conferences, trainin! pro!rammes, availa$ility of corporate !ifts, and production of mar%etin! material, e8hi$ition $anners, and e8hi$itions as and hen they $ecome availa$le.

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Once you %a(e completed t%is form:

Please use the Save As... option and rename the file and keep for your records. Then mail the completed document !along "ith re#uired documentation$ to%

informationCBisan.com
&r Fa' the completed document !along "ith re#uired documentation$ to%

D++ E8F $2+8 213 $2$

Please mark Application Form for the attention of% Mr (ee )ammond

Make payment via *ank Transfer to +,SA- (td

9S:2 Sort 2ode: Account Num$er: I:AN: S ift 2ode:

,+/+7/&; <",(7<+= >:771I)4,++7&;<",(7<+= 1I)4>:&"+?4

Ensure that Agency Name is used as the 0ransfer 3eference G:ender is to pay all #an9 Transaction Fees and Currency Con(ersion C%argesG

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Agent Application Form QISAN 2014

Ver. 21-01-14