Education Agent Application Form

About this form

Thank you for your interest in becoming an education agent with Hillshire International College. Once we receive your
application, we will acknowledge we have received your application within 3 working days of receipt. If you require any
assistance in completing this form, please contact us by phone or email. Please ensure you include the details of two
referees who can support your application.
Once we have assessed your application (within 10 working days of receipt), we will be in touch with you in writing
regarding the outcome of the application. If the application is approved, we will send you an agreement in writing for signing
and you will need to participate in an induction with us thereafter.
You can send this form back to us by post or email at marketing@hillshire.edu.au

Company details

Company name (legal and trading name)

ACN and ABN

Address

Website address

Phone number/s

Email address

Referees

Company name

Contact person name

Contact person position

Phone number

Email address

Referees

Company name

Contact person name

Contact person position

Phone number

Email address

Education Agent Declaration

Name of education agent representative

Education agent representative position

Signature

Date

Privacy Notice

I Agree to Privacy Notice Below

Privacy Notice

Hillshire International College is required to collect education agents’ personal information. This may be shared
with the Australian Government as required for the purposes of:

promoting compliance with the ESOS Act and the National Code;
assisting with the regulation of Agents;
promoting compliance with the conditions of a particular student visa or visas, or of student visas generally; or
facilitating the monitoring and control of immigration.

Information about education agents can also be accessed by all registered providers through PRISMS and
includes:

the outcome of the enrolments
the percentage of completed CoEs by the education agent
the number of CoEs created with the education agent’s involvement against the total number of CoEs created for the provider.