International Representative Application Form
1. List the services your organization provides to students:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
2. Do you charge students for these services? ______ Yes ______ No
If yes, please explain:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
3. How long has your agency existed? ________________________________________
4. Have you ever recruited students for Saint Leo University in the past? ____ Yes ____ No
5. Do you recruit? _____ Undergraduate Students _____ Graduate _____ Both
Name of Owner/Director __________________________________________________
Agency’s Name __________________________________________________
Address __________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
Telephone No _________________________________ (Day)
_________________________________ (Evening)
Fax No __________________________________________________
Email __________________________________________________
Website __________________________________________________
Contact Person __________________________________________________
Position __________________________ Date ___________________
Federal ID No __________________________________________________
(US Social Security No. Or Tax Payer ID No. if operating office in the United States)
6. How many students have you recruited to the US during the past year?
_________________________________________________________________________________________________
_________________________________________________________________________________________________
7. List the schools your agency currently represents in the U.S.:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
8. In what countries and major cities does your organization recruit? Please be sure to
attach a contact list for all of your branch offices.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
9. List government recruitment licenses registered with your agency:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
10. List any memberships with professional or government organizations:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
11. What services does your agency provide to the universities you represent?
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
12. Submit any other information about your agency which you feel is relevant to this
application:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
PLEASE RETURN TO:
Maribeth Stevens
Executive.Director
Center.for Global Engagement
Saint Leo University
University Campus - MC 2008
33701 State Road 52, Saint Leo, FL 33574-6665
Email: maribeth.stevens@saintleo.edu
Phone: (352) 588-8284
Fax: (352) 588-7529