# Northern College - International Agent Authorization Form

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| Type | PDF |
| Size | 101 KB |

[Open original PDF →](https://www.northerncollege.ca/uploads/2025/07/Northern-College%E2%80%93InternationalAgentAuthorizationForm-FormStyle.pdf)

Referenced from: [International Recruiters & Agents](/pages/international/agents/)

## Document text

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## Northern College - International Agent Authorization Form

## Student Information

- Full Name:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

- Student ID or Applicant Number (if available):

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

- Email Address:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

## Authorized Agent Information

- Agency Name:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

- Agent Name (if applicable):

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

- Email Address:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

- Phone Number (optional):

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

## Authorization Statement

I, the undersigned, confirm that I am authorizing the above-listed international agent to represent me in matters related to my application and/or enrolment at Northern College.

By submitting this form, I grant permission for Northern College to communicate with this agent regarding my application and enrolment status.

This authorization is effective as of:

Effective Date: \_\_\_\_ / \_\_\_\_ / \_\_\_\_\_\_ (DD/MM/YYYY)

Student Signature:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Date: \_\_\_\_ / \_\_\_\_ / \_\_\_\_\_\_ (DD/MM/YYYY)

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<small>Source: [https://www.northerncollege.ca/uploads/2025/07/Northern-College%E2%80%93InternationalAgentAuthorizationForm-FormStyle.pdf](https://www.northerncollege.ca/uploads/2025/07/Northern-College%E2%80%93InternationalAgentAuthorizationForm-FormStyle.pdf)</small>