# Northern College - Change of International Agent Confirmation Form

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| Type | PDF |
| Size | 111 KB |

[Open original PDF →](https://www.northerncollege.ca/uploads/2025/07/NorthernCollege%E2%80%93ChangeofInternationalAgentConfirmationFormFormStyle.pdf)

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

## Document text

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## Northern College - Change of International Agent Confirmation Form

## Student Information

- Full Name:

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

- Student ID or Applicant Number (if available):

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

- Email Address:

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

## New Agent Information

- Agency Name:

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

- Agent Name (if applicable):

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

- Email Address:

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- Phone Number (optional):

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## Previous Agent Information

- Agency Name:

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

- Agent Name (if applicable):

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## Confirmation Statement

- I, the undersigned, confirm that I have chosen to work with the above-listed new international agent in relation to my application and/or enrolment at Northern College. I authorize Northern College to recognize this agent as my official representative and understand they will be eligible for commission in accordance with college policies.

I further confirm that I have notified my previous agent of this decision and understand that all future communications and support will be managed by my new agent. I will take the responsibility of not informing the previous agent about the change or any dispute/financial obligations caused by this change.

This change of representation is effective as of:

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

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

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<small>Source: [https://www.northerncollege.ca/uploads/2025/07/NorthernCollege%E2%80%93ChangeofInternationalAgentConfirmationFormFormStyle.pdf](https://www.northerncollege.ca/uploads/2025/07/NorthernCollege%E2%80%93ChangeofInternationalAgentConfirmationFormFormStyle.pdf)</small>