Education Agent Information Update Form

Education Agent Information Update Form

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Please complete this form to update any changes to your business details and/or location and return it to Austra College.

Section 1: Update Company Details

Company Name:

Trading Name (if different from Company Name:

Company Address

Address Line 1

Address Line 2

City

State

Zip Code

Postal Address:

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number

Fax Number:

Website / URL

Social Media Page Links:

International Office Locations

Section 2: Update Director and Employee Details

Person 1

Name:

Position:

Qualification and Experience Summary:

Membership of Education Agent Professional Bodies:

Person 2

Name

Position:

Qualification and Experience Summary:

Membership of Education Agent Professional Bodies:

Section 3: Update Main Contact Details

Layout

Name

Position

Phone

Section 4: Additional Information

Please provide any additional changes to be notified to the Institute:

Section 5: Declaration

In signing this form, you declare that

The answers and details provided in this application are true, accurate and complete.
You acknowledge and agree to the privacy statement provided below.

Privacy Statement: All information collected, used or disclosed by the Institute is confidential and is protected by the Privacy Act 1988 and other relevant legislation. The Institute’s policy is outlined in Privacy Policy and Procedure available from our website. Information about Agents or students may be made available to Commonwealth and State agencies if required to provide the information by law.

Layout

Name

Date

Education Agent Information Update Form