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NJIT Agent Application Form

NJIT Agent Application Form

GENERAL INFORMATION

Agency name: *

Agency mailing address (Headquarters) Street:

City:

State/Province (if applicable):

Country:

Postal Code (if applicable):

Agency phone number:

Agency e-mail: *

Agency website:

PRIMARY CONTACT

Contact person for signing agreements:

Title:

E-mail:

AGENCY INFORMATION

Year of agency establishment:

List of countries represented by agent:

Agency owner name(s):

Total number of agent offices:

Country(ies) of office location(s):

City(ies) of office location(s):

Total number of employees:

Is the agency certified by AIRC:

Yes

No

List any professional affiliations/memberships (NAFSA, etc.):

List any relevant conferences attend by agency representatives-past or current (NAFSA, ICEF, etc.):

Does your agency work with sub-agents:

Yes

No

Has the company or any individual within the company ever been involved in litigation, arbitration, administrative actions or legal disputes?

Yes

No

AGENCY SERVICE INFORMATION

Does the agency serve as a testing center (IELTS, TOEFL, etc.):

Yes

No

Please specify which exams:

List the services that your agency provides to students (counseling, document preparation, visa counseling, travel arrangements, etc.):

Please describe any special features of your agency that sets it apart from others:

AGENCY DATA

How many students does your agency (across all countries and from all offices ) provide services to on an annual (yearly) basis:

Most popular countries of placement of your students:

1)

2)

3)

Average number of students who apply to universities in the United States on an annual/yearly basis:

Average number of students who enroll in universities in the United States on an annual/yearly basis:

Examples of U.S. universities with whom you have an active agent agreement and send your largest amount of students:

Do you have a partnership with any other universities in New Jersey? If so, please specify:

Is there anything else you would like us to know:

STUDENT INFORMATION

Estimated percentage of students for the following:

Undergraduate/bachelor’s programs: %

Master’s degree programs: %

PhD. programs: %

ESL programs: %

What percentage of your students are seeking conditional admission for English training (ESL):

Undergraduate: %

Graduate: %

Most popular majors your students are seeking:

1)

2)

3)

4)

5)

Other:

NJIT-SPECIFIC INFORMATION

Have you ever sent applications to NJIT:

Yes

No

Estimated number of applications sent in the last year?

How did you hear about NJIT:

How many students do you estimate would apply to and enroll in NJIT on an annual basis:

Please explain why you believe your agency would be a good fit for NJIT:

Please provide a brief proposal for the marketing and promotion of NJIT (webinars, in-person events, etc.):

REFERENCES

Please provide two references from a U.S. university with whom you have an agreement:

University #1 name:

Contact name:

Contact e-mail:

University #2 name:

Contact name:

Contact e-mail:

CONFIRMATIONS

*

I declare that the information in this application is true and correct.

*

I agree to abide by NAFSA’s Statement of Ethical Principals.

Name of person completing the application:

Title:

Thank you for your interest in representing NJIT. At this time, we are not accepting new agents. Please check back during the new academic year.

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