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Certificate III in Individual Support
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Certificate IV in Kitchen Management
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Home
About us
Courses
Domestic Students
Certificate III in Individual Support
Certificate IV in Ageing Support
Certificate IV in Kitchen Management
International Students
Certificate III in Painting and Decorating
Diploma of Building and Construction
Certificate III in Carpentry
Certificate IV in Building & Construction
Student Information
Campus Life
Student Hanbook
Policies
Admission-and-Enrolment-Policy-and-Procedure
Critical Incident Policy
Student Code of Conduct
USI Policy and Privacy Statement
Course Progress Policy and Procedure
Student Complaints and Appeals Policy and Procedure
Fee Refund Policy and Procedure
P13_Course Completion within Expected Duration Policy
P16_Change of Course Policy and Procedure
P30_Access and Equity Policy
P31_Anti-Discrimination and Anti-Bullying Policy and Procedure
P11_Student Support and Welfare Policy
Forms
Request for Release
Request for Issuance of Academic Results
Change of Course Form
Student Concern From
Critical Incident Form
Withdrawal from Course and Cancellation of CoE Form
Deferral Suspension and Cancellation Form
FEE Refund Form
Student Personal Details Form
USI Consent Form
Student Request Form
Student Change of Contact Details Form
Support Services
USI
Useful Links
Emergency and Medical Services
Pre-Departure Information
About Australia
Living in Melbourne
Pre-Departure & Pre-Arrival
Tuition Protection Services
ESOS Regulatory Framework
Australian Education Framwork
Visa and Immigration Information
Agents
Agent List
Agent Code of Ethics
Contact us
Home
About us
Courses
Domestic Students
Certificate III in Individual Support
Certificate IV in Ageing Support
Certificate IV in Kitchen Management
International Students
Certificate III in Painting and Decorating
Diploma of Building and Construction
Certificate III in Carpentry
Certificate IV in Building & Construction
Student Information
Campus Life
Student Hanbook
Policies
Admission-and-Enrolment-Policy-and-Procedure
Critical Incident Policy
Student Code of Conduct
USI Policy and Privacy Statement
Course Progress Policy and Procedure
Student Complaints and Appeals Policy and Procedure
Fee Refund Policy and Procedure
P13_Course Completion within Expected Duration Policy
P16_Change of Course Policy and Procedure
P30_Access and Equity Policy
P31_Anti-Discrimination and Anti-Bullying Policy and Procedure
P11_Student Support and Welfare Policy
Forms
Request for Release
Request for Issuance of Academic Results
Change of Course Form
Student Concern From
Critical Incident Form
Withdrawal from Course and Cancellation of CoE Form
Deferral Suspension and Cancellation Form
FEE Refund Form
Student Personal Details Form
USI Consent Form
Student Request Form
Student Change of Contact Details Form
Support Services
USI
Useful Links
Emergency and Medical Services
Pre-Departure Information
About Australia
Living in Melbourne
Pre-Departure & Pre-Arrival
Tuition Protection Services
ESOS Regulatory Framework
Australian Education Framwork
Visa and Immigration Information
Agents
Agent List
Agent Code of Ethics
Contact us
Menu
Home
About us
Courses
Domestic Students
Certificate III in Individual Support
Certificate IV in Ageing Support
Certificate IV in Kitchen Management
International Students
Certificate III in Painting and Decorating
Diploma of Building and Construction
Certificate III in Carpentry
Certificate IV in Building & Construction
Student Information
Campus Life
Student Hanbook
Policies
Admission-and-Enrolment-Policy-and-Procedure
Critical Incident Policy
Student Code of Conduct
USI Policy and Privacy Statement
Course Progress Policy and Procedure
Student Complaints and Appeals Policy and Procedure
Fee Refund Policy and Procedure
P13_Course Completion within Expected Duration Policy
P16_Change of Course Policy and Procedure
P30_Access and Equity Policy
P31_Anti-Discrimination and Anti-Bullying Policy and Procedure
P11_Student Support and Welfare Policy
Forms
Request for Release
Request for Issuance of Academic Results
Change of Course Form
Student Concern From
Critical Incident Form
Withdrawal from Course and Cancellation of CoE Form
Deferral Suspension and Cancellation Form
FEE Refund Form
Student Personal Details Form
USI Consent Form
Student Request Form
Student Change of Contact Details Form
Support Services
USI
Useful Links
Emergency and Medical Services
Pre-Departure Information
About Australia
Living in Melbourne
Pre-Departure & Pre-Arrival
Tuition Protection Services
ESOS Regulatory Framework
Australian Education Framwork
Visa and Immigration Information
Agents
Agent List
Agent Code of Ethics
Contact us
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AGENT APPLICATION FORM
AGENT APPLICATION FORM
COMPANY
Agent/Agency (Legal Name)
Trading Name
Business/Mara/ Registration Number:
ABN/ACN
CONTACT DETAILS
Title
Dr.
Miss
Mr.
Mrs.
Ms.
Prof.
Rev.
Given Name
Family Name
Possition
Email
Phone
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
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
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Years as an education agent
Number of years
Has the company or any individual within the company ever been involved in past, pending, threatened or potential litigation, arbitration, administrative actions or other disputes?
(Required)
Yes
No
Have you or your staff completed the EATC Training (PIER Online)? http://www.pieronline.org/eatc/
(Required)
Yes
No
If yes, please provide details:
No. of students recruited to Australian Institutions each year?
Please list the popular courses amongst your students:
How do you intend to promote International Technical Institute (ITI) in your office?
How many students do you intend to recruit to ITI each year?
No of staff:
List member of Associations:
Services provided to students:
Number of offices (locations):
(If you have other office(s), please send email list of offices to marketing@iti.edu.au if more than one)
Do you recruit students to countries other than Australia, If yes, please list below
Do you represent educational institutions in Australia? If yes, please list below:
Section Break
Reference 1
Contact Name
Organisation
Position
Email
Phone
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
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
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Reference 1
Contact Name
Organisation
Position
Email
Phone
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
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
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Organisational Chart: (If available, please attach)
Max. file size: 64 MB.
Business Profile/Strategic Plan (If available, please attach)
Max. file size: 64 MB.
Consent
(Required)
I agree to the privacy policy.
I am interested in representing Gippsland Trade Institute Pty Ltd T/A International Technical Institute as an education agent and I agree to do so in an honest and professional manner. I agree to:
• Regularly monitor policies and changes to the policies as reported on the Department of Home Affairs (DHA)website.
• Regularly monitor policies and regulations and changes to these policies and regulations as reported on thewww.education.gov.au website.
• I have read the National Code 2018 and agree to adhere to the relevant Standards.
• I declare and take all reasonable steps to avoid conflicts of interest with my duties as an education agent ofITI
Examples of conflicts of interest include, but are not limited to:
> When the agent charges services fees to both overseas students and ITI for the same service.
> Where an education agent has a financial interest in ITI; or
> Where an employee of an education agent has a personal relationship with an employee of ITI.
Please attach a separate sheet to disclose any conflicts of interests
• I declare that I have read AUSTRALIAN INTERNATIONAL EDUCATION AND TRAINING Agent Code of Ethicsattached with this application (can download from https://internationaleducation.gov.au/News/Latest-News/Documents/Australian%20International%20Education%20and%20Training%20-%20Agent%20Code%20of%20Ethics.pdf)
FULL NAME OF THE PERSON AND ROLE
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Date
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