Bodwell Agent Application

Agent Info

Agency profile, address, and recruitment information.

Basic Info

* Agency Name

* Agency Website

* General Email Address

* Establishment Date

Business License Number

* Phone (Main)

Example: +1 604 998-1000

Mailing Address

* Street

* City

Province / State / Region

* Country

* Postal Code

Profile

* Programs primarily represented

* Country Representing #1

Country Representing #2

Country Representing #3

Country Representing #4

Country Representing #5

* Where did you hear about Bodwell?

* How would you promote Bodwell programs?

How many students did you send to Canada last year? And for which program?

Contact Info

Main contact and director/president information.

Main Contact Person

* Position Title

* Title

* Sex

* First Name

* Last Name

* First Language

Second Language

* Nationality

* Email Address

* Phone

Director or President

Same as main contact

* Position Title

* Title

* Sex

* First Name

* Last Name

* First Language

Second Language

* Nationality

* Email Address

* Phone

Reference Info

Optional institutional references.

Institution #1

Institution Name

Position Title

Title

First Name

Last Name

Sex

First Language

Email Address

Phone

Street

City

Province / State / Region

Country

Postal Code

Institution #2

Institution Name

Position Title

Title

First Name

Last Name

Sex

First Language

Email Address

Phone

Street

City

Province / State / Region

Country

Postal Code

Attach Files

Upload business documents or supporting files.

Attachment 1

Attachment 2

Attachment 3

Attachment 4

Attachment 5

Comments

Additional notes for the marketing team.

Any comments to leave?

Agent Application

Agent Info

Basic Info

Mailing Address

Profile

Contact Info

Main Contact Person

Director or President

Reference Info

Institution #1

Institution #2

Attach Files

Comments

Application Submitted