You are on page 1of 1

AMITY GLOBAL BUSINESS SCHOOL

PROSPECTIVE AGENT INFORMATION FORM

Name of the Company


Agency Signatory & Title
Physical Address
Mailing Address
(If different from above)
Phone and Mobile
Fax
Website
Email
Contact Person
Business Outfit Details (Infrastructure)
Authorization by respective government to do
recruitment or links to local authorities
Years of Experience in the Education Field
Average number of recruitment done in a year
Name few countries, which you have recruited
the students for
Name few universities, institutions, etc with whom
you have tie-up already
Reference 1
References (minimum 2, please provide their
names, addresses, contact email addresses and
numbers)

Reference 2

Markets (country) which would prefer to work with


us (Select 1 Only)
Others (if any)

FRM-048

Page 1 of 1

Version 1