Agency Name:

Agent Contact Name:

Email Address:

Website:

Phone Number:

Fax Number:

Mailing Address:
Address Line 1:
Address Line 2:
City:
Province:
Country:
Postal/Zip Code:

1)

In what year was your Agency Incorporated/Established

2)

What is the main focus of your business?

3)

How many students do you place each year?

4)

What are your three top countries?

5)

How many students do you place in Canada each year?

6)

What Institutions do you currently represent?

7)

What services do you provide to students?

8)

Have you or a staff member ever visited Canada?

9)

Have you or a staff member ever met with a representative of Acadia University? If so, where?

10)

How did you learn about Acadia University and/or our English Language program?

11)

What makes your agency different? What are your strong points?

Acadia University requires a minimum of 3 references and a copy of an agency license. Please list the references below and send a copy of your license by fax to: 902-585-1068.

I acknowledge that the information provided in this agent questionnaire is true.

Representative
Name
Title
Date