International Agent Application

All fields required.

Agency Name

Agency Mailing Address - Street:

Agency Mailing Address - City:

Agency Mailing Address - State/Province:

Agency Mailing Address - Country:

Agency Mailing Address - Zip/Postal Code:

Agency Phone Number:

Agency Email Address:

Agency Homepage URL:

Primary Contact Person - Name:

Primary Contact Person - Title:

Primary Contact Person - Phone Number:

Primary Contact Person - Email Address:

Year of Agency Establishment:

Cities/Countries where you actively recruit:

Describe your marketing and recruitment strategy:

Do you charge students or families for ANY of your services?

Yes

If YES, please explain:

Annual number of students you expect to send to NMSU:

Are you a member of AIRC?

Yes

If YES, date of membership:

Please provide a brief company profile outlining your previous work and education background:

Is there anything else you would like us to know?

Do you declare that the information in this application and all supporting documentation is true and correct?

Yes

By providing this information, you agree to allow NMSU to send you occasional communications.