AP
PLICATIO
Company Name: _____________________________ Representative in Canada:
Principal Contact: ____________________________ Contact Name(s):
Address: ____________________________________ ________________________________
____________________________________ ________________________________
____________________________________ Address: _______________________
____________________________________ ________________________________
Telephone: (___)_(___)_________________________ City: ___________________________
Cell: (___)_(___)______________________________ E-mail: ________________________
E-mail: _____________________________________ Telephone: ( )_________________
Website: http://______________________________ _
Skype: ______________________________________
COMPANY INFORMATION:
From What Countries Are Your Students?
1.
2.
3.
To Which Countries Do You Send Your Students?
Company History/Profile:
Relevant Experience in Education Sector:
Canadian and Other Institutions Your Company Represents:
English Language Programs Telephone: +1-519-824-4120 Ext 53575
University of Guelph Fax: +1-519-767-1114
Open Learning and Educational Support E-mail: eslmktng@uoguelph.ca
160 Johnston Hall Website: www.eslguelph.ca
Guelph, ON, CANADA N1G 2W1 www.uoguelph.ca
APPLICATION FOR RECRUITMENT REPRESENTATIVE
Promotional Activities to Recruit Students:
Professional Associations and Membership:
Charges to Students:
3 Education Institution References (where students have successfully been enrolled):
School Name: ___________________________________________________________________
Contact: _________________________________ Title: ________________________________
Address: ________________________________________________________________________
City: ________________________ Prov/State: _____________Postal/Zip Code: _____________
Tel: ( ) ( ) ___________________________ E-Mail: _______________________________
School Name: ___________________________________________________________________
Contact: _________________________________ Title: ________________________________
Address: ________________________________________________________________________
City: ________________________ Prov/State: _____________Postal/Zip Code: _____________
Tel: ( ) ( ) ___________________________ E-Mail: _______________________________
School Name: ___________________________________________________________________
Contact: _________________________________ Title: ________________________________
Address: ________________________________________________________________________
City: ________________________ Prov/State: _____________Postal/Zip Code: _____________
Tel: ( ) ( ) ___________________________ E-Mail: _______________________________
Please Print:
Name: _________________________________ Signature: ____________________________
Title: ___________________________________ Date: ________________________________
If you have additional questions, please email:
University of Guelph, English Language Programs Marketing Team: eslmktng@uoguelph.ca
click to sign
signature
click to edit