Edmonds CC Prospective Agency Form
Thank you for your interest in becoming a partner. Please complete the form below.
Contact Information
Agency/Business Name (Enter "N/A", if not applicable) *
Your answer
First Name (main contact person - NOT the signer) *
Your answer
Last Name (main contact person - NOT the signer) *
Your answer
Contact Person's Job Title (Enter "N/A", if not applicable) *
Your answer
Contact Person's Email address *
Your answer
Contact Person's Phone number *
Your answer
First Name (signer of the agreement, not the contact person) *
Your answer
Last Name (signer of the agreement, not the contact person) *
Your answer
Signer's Job Title *
Your answer
Signer Email address *
Your answer
Signer Phone number *
Your answer
Address *
Your answer
Fax number
Your answer
Website
Your answer
Agency Details
1) Please enter the number of years your agency has been in operation *
Your answer
2) Please select the clientele you serve (may check more than one)
3) Please list the countries where you recruit students
Your answer
4) Please select the programs your students are interested in (may check more than one)
5) Please enter the names of all institutions abroad that you work with. Include community colleges, universities, and/or ESL schools.
Your answer
6a) How many new students have you sent in the past 12 months have successfully enrolled (registered for class and paid tuition) at an institution abroad? *
Your answer
6b) Of those students, how many successfully enrolled at a community college? *
Your answer
7) How did you learn about Edmonds Community College?
Your answer
8) If you become an official partner of Edmonds Community College, how would you plan to promote the college?
Your answer
9) Are you a member (certified) of ​AIRC - American International Recruitment Council​? *
Your answer
If yes, when it will be expired? *
Your answer
Professional References
Please provide contact information for 2 oversea references from colleges, universities, and/or ESL schools that your agency works with. If we are unable to receive feedback from your references within two weeks, we will not proceed in considering your partnership.
Reference #1 - First Name *
Your answer
Reference #1 - Last Name *
Your answer
Reference #1 - Name of institution *
Your answer
Reference #1 - Country of the Institution *
Your answer
Reference #1 - Email *
Your answer
Reference #1 - Phone number *
Your answer
Reference #2 - First Name *
Your answer
Reference #2 - Last Name *
Your answer
Reference #2 - Name of institution *
Your answer
Reference #2 - Country of the Institution *
Your answer
Reference #2 - Email *
Your answer
Reference #2 - Phone number *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of EdCC. Report Abuse