GLOBAL MARKETING AGREEMENT APPLICATION

* Required field

If you have not read the entire International Agency Information website and
the Global Marketing Agreement , do so now. *

1. I have read the International Agency Information and the Global Marketing Agreement, and accept the terms therein. *
      Yes       No

2. Agency Information

Full agency name (IN ENGLISH): * (Please note: we do not accept personal names as official agency names; all commissions will be issued to the official agency name in English.)


Full mailing address: *


Full office address (if different from mailing address):


President / Director name: *
  

USA counselor name:


Phone: *

Fax:

Email Adress: *


URLl:


3. How long has your agency been operating as an educational consultant? *
  year(s)     month(s)
 
4. Number of USA counselors/advisors? *

 
5. Is your agency a designated sponsor under the U.S. Exchange Visitor Program? *
Yes       No

 
6. How many students do you send to the U.S. yearly? *

 
7. From which country or countries do your students come, and what are their nationalities? Please provide a complete list in the box below, following the example provided. *

(Example) Country: Japan

(Example) Nationalities: Japanese

Country: *

Nationalities: *

Country:

Nationalities:

Country:

Nationalities:

Country:

Nationalities:

 
8. Of the students who you send to the U.S. yearly, how many intend to study: *
   ESL only
   as an undergraduate ^
  in short-term or special programs ^      
^ (College students may be required to complete some ESL prior to beginning academic studies )
 
9. The business named on this application is properly licensed by an appropriate governmental department to conduct business in the area of educational counseling/consulting. *
      Yes       No
 
10. The business named on this application is able to receive commission payments made payable to the business name, in English, by wire or by check. *
      Yes       No
 
11. Does at least one employee of the business named on this application currently live in the United States? *
      Yes       No

If yes, indicate the name and status of all employees of the business who live in the United States:

    a. First Employee's Name :

    b. US Citizen / Permanent Resident ?       Yes       No

    c. If the answer to b. is "No", is the employee a Non-Immigrant?       Yes       No

    If the employee is a Non-Immigrant, write visa type/status in the space below:

    d. List all other Employees of the business named on this application that live in the United States,    and their visa type/status, following the example below.


   ( Example : Yoko Takahashi, Non- Immigrant, F-1 Visa )

12. The business, or any employee or representative of the business, is now or has been involved in a legal dispute, or has received notice of a possible future legal dispute, related to educational counseling/consulting. *
      Yes       No

If yes, explain here:
 
13. I certify that the answers and information I provided above are, to the best of my knowledge,truthful and correct. I understand that Seattle Central Community College (SCCC) reserves the right to terminate SCCC's relationship with the business or any of the business' employees or representatives if SCCC discovers, or has a reasonable belief, that any answer or information provided in this application is false. *
      Yes       No