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Referral Agent Information Form

Referral Agent Information Form

As of November 27, 2017, the International Office of Herzing College considers CANAM Consultants Limited, as its exclusive representative in India. All Indian agents requesting new agreements with Herzing College, after Nov.27,2017, will be referred to CANAM Consultants Limited.

Applications for March, April and May 2019 will be closed as of Friday, November 23, 2018. Applications for June 2019 and beyond will be accepted starting January 7th, 2019.  

Please be advised that as of January 7, 2019, Herzing College will only accept those applications having an IELTS overall score of 6.5, with no band less than 6.0.

Agent Profile:

Date:

Name of Agent:

Name of Company:

Country Represented:

Company Address:

Tel:

Cell:

Fax:

E-mail address:

Website:

Business Registration #:

Years in Business:
years in Education
years in Travel
years in Immigration
years in other fields - Please specify:

Name of owner:

Contact Person (if not owner):

Do you have offices in other cities? (if so, please list):

Are you representing other countries? (if so, please list):

How do you plan to market our College?