Northern College - International Agent Authorization Form
__________________________________________
| Type | |
| Size | 101 KB |
Referenced from: International Recruiters & Agents
Document text
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)