Company / Business Name *

Trading name (if different from Company name)

ABN *

Migration Agency Number (if applicable)

Years Trading as Education Agent

Name of Director/ CEO *

Country of Company/ Business Registration

Business Address *

Phone *

Email *

Website *

Please describe your business activities

Number of staff

Number of international offices

Locations of international offices

Person 1

Name *

Position

Phone *

Email *

Person 2

Name *

Position

Phone *

Email *

What are your target markets?

What marketing strategies will you use to promote our courses?

How many Australian education institutions are you currently representing?

How many students have you referred to Australian educational institutions in the past 2 years?

In regards to fulfilling our responsibilities as an education agent as required by the National Code 2018.

Have you or any of your staff completed the Education Agents Training Course (EATC) available through www.pieronline.org?YesNo

If YES, please list who has completed the course.

Do you have a comprehensive understanding of the requirements of the ESOS Act and National Code?YesNo

Do you regularly monitor the Australian Department of Immigration and Citizenship (DIAC) website (www.immi.gov.au) and the Department of Education?YesNo

Are you willing to comply with the requirements of our RTO regarding advertising, course materials and application procedures, and provide accurate information to students?YesNo

Are you prepared to use the marketing materials provided by our RTO to promote our courses?YesNo

Please provide any other information that you think will support your application

Please provide details of at least 2 Australian educational institutes that we can contact for a reference.

Institution 1

Name of Institution *

Contact Person *

Position

Phone *

Email *

From Date *

To Date *

Institution 2

Name of Institution *

Contact Person *

Position

Phone *

Email *

From Date *

To Date *

ABN or ACN Certificate (if applicable)

Business Profile *

PIER (or MARA) Certificate *

Attach Flyers

By submitting this agreement form, you declare that

• You will market MINT’s courses with integrity and accuracy as outlined in the National Code of Practice 2018 (For Registration Authorities and Providers of Education and Training to Overseas Students).

• You have read and understood the extract from the ESOS Act 2000 Obligations of Agents. (Details can be found on https://internationaleducation.gov.au/ ).

• The answers and details provided in this application are true, accurate and complete.

• Mint Training is authorised to contact the referees listed to collect information about my conduct and services.

• You acknowledge and agree to the privacy statement provided below.

Privacy Statement: All information collected, used or disclosed by Mint Training is confidential and is protected by the Privacy Act 1988 and other relevant legislation. Mint Training policy is outlined in the Information Privacy Policy available from our website. Information about Agents or students may be made available to Commonwealth and State agencies if required to provide the information by law.

Signature *

I Accept

Which course(s) would you like to enrol into? (If applying as a “package”, please tick all courses.)

Business and Management BSB40520 Certificate IV in Leadership and Management (CRICOS code: 104003K)BSB50420 Diploma of Leadership and Management (CRICOS code: 104373F)BSB60420 Advanced Diploma of Leadership and Management (CRICOS code: 106556E)BSB80120 Graduate Diploma of Management (Learning) (CRICOS code: 106557D)BSB80320 Graduate Diploma of Strategic Leadership (CRICOS code: 104481B)

Hospitality SIT30821 Certificate III in Commercial Cookery (CRICOS code: 112962G)SIT40521 Certificate IV in Kitchen Management (CRICOS code: 109558A)SIT50422 Diploma of Hospitality Management (CRICOS code: 114796M)SIT60322- Advanced Diploma of Hospitality Management (CRICOS code: 114797K)

Carpentry and Joinery CPC30220 Certificate III in Carpentry (CRICOS code: 116162G)

Aged Care CHC33021 Certificate III in Individual Support (CRICOS code: 116161H)

Information Systems ICT60220 Advanced Diploma of Information Technology (CRICOS code: 116163F)

ELICOS General English (Elementary to Upper Intermediate) (CRICOS code: 115401E)

Intake Month *—Please choose an option—JanFebMarchAprilMayJuneJulyAugSepOctNovDec

Intake Year *—Please choose an option—2024202520262027202820292030

Campus *—Please choose an option—MelbourneAdelaide

Applying visa from *—Please choose an option—Onshore (in Australia)Offshore (Overseas)

Are you applying for RPL or Credit Transfer?YesNoMaybe

Surname *

Given names *

Date of Birth *

Gender * MaleFemaleUndeclared

Enter your contact details

Home phone

Work phone

Mobile *

Email address*

Alternative email address *

What is the address of your usual residence?

Please provide the physical address (street number and name not post office box) where you usually reside rather than any temporary address at which you reside for training, work or other purposes before returning to your home. If you are from a rural area use the address from your state’s or territory’s ‘rural property addressing’ or ‘numbering’ system as your residential street address. Building/property name is the official place name or common usage name for an address site, including the name of a building, Aboriginal community, homestead, building complex, agricultural property, park or unbounded address site.

Building/ property name

Flat/unit details

Street or Lot Number (e.g. 205 or Lot 118) *

Street name *

Suburb, locality or town *

State/territory *

Postcode *

Country *

What is your postal address? (if different from above)

Building/ property name

Flat/unit details

Street or Lot Number (e.g. 205 or Lot 118)

Street name

Suburb, locality or town

State/territory

Postcode

Country

Passport Number *

Expiry Date *

Country of Passport *

What type of visa are you currently holding (if currently holding a visa)

If currently enrolled with any other education provider, please provide a copy of your current student visa and all eCoEs that you are holding with your application *

Student VisaVisitor VisaWorking Holiday VisaWork and Travel VisaOther

Visa Expiry Date *

Name of English Test Taken —Please choose an option—IELTS (Academic)TOEFL PBTOEFL IBTCAEPTE

Test Score

Date Test Taken

Do you consider yourself to have a disability, impairment or long-term condition?

YesNo

If you indicated the presence of a disability, impairment or long-term condition, please select the area(s) in the following list:

You may indicate more than one area) Please refer to the Disability supplement at the back of this form for an explanation of the following disabilities

N/AHearing/deafPhysicalIntellectualLearningMental IllnessAcquired brain impairmentVisionMedical ConditionOther

What is your highest COMPLETED school level
If you are currently enrolled in secondary education, the Highest school level completed refers to the highest school level you have actually completed and not the level you are currently undertaking. For example, if you are currently in Year 10 the Highest school level completed is Year 9. *—Please choose an option—Year 12 or equivalentYear 11 or equivalentYear 10 or equivalentYear 9 or equivalentYear 8 or belowNever attended school

Other information(if applicable)

Certificate I or Certificate II—Please choose an option—Qualification has been completed in AustraliaQualification has been completed overseas and recognised formally in Australia by AEI-NOOSRQualification has been completed overseas but not recognised in Australia

Advanced Diploma/Associate Degree—Please choose an option—Qualification has been completed in AustraliaQualification has been completed overseas and recognised formally in Australia by AEI-NOOSRQualification has been completed overseas but not recognised in Australia

Certificate III—Please choose an option—Qualification has been completed in AustraliaQualification has been completed overseas and recognised formally in Australia by AEI-NOOSRQualification has been completed overseas but not recognised in Australia

Bachelor Degree—Please choose an option—Qualification has been completed in AustraliaQualification has been completed overseas and recognised formally in Australia by AEI-NOOSRQualification has been completed overseas but not recognised in Australia

Certificate IV—Please choose an option—Qualification has been completed in AustraliaQualification has been completed overseas and recognised formally in Australia by AEI-NOOSRQualification has been completed overseas but not recognised in Australia

Graduate Certificate/Graduate Diploma—Please choose an option—Qualification has been completed in AustraliaQualification has been completed overseas and recognised formally in Australia by AEI-NOOSRQualification has been completed overseas but not recognised in Australia

Diploma—Please choose an option—Qualification has been completed in AustraliaQualification has been completed overseas and recognised formally in Australia by AEI-NOOSRQualification has been completed overseas but not recognised in Australia

Masters Degree or higher—Please choose an option—Qualification has been completed in AustraliaQualification has been completed overseas and recognised formally in Australia by AEI-NOOSRQualification has been completed overseas but not recognised in Australia

Year 12 or equivalent —Please choose an option—Qualification has been completed in AustraliaQualification has been completed overseas and recognised formally in Australia by AEI-NOOSRQualification has been completed overseas but not recognised in Australia

These are people that Mint International College may need to contact in an emergency during your participation in training. Please ensure that the people named are aware that they have been nominated as emergency contacts and agree to their details being provided to Mint International College.

Name *

Relationship to you *

Address *

Home Phone

Work Phone

Mobile Phone *

Email *

Company name

Contact person

Phone

Email

Proof of English Language Proficiency

Copy of your passport *

Copy of your visa (if you are currently in Australia or have a valid one) *

Copies of your highest qualification (overseas and in Australia)

Any other documents to support your application

If applying for a USI additional copies of support documents as outlined in the USI section of the application.

Any current or previous CoEs held in Australia.

A release letter from your current education provider, current and future COEs from current provider (if applicable and applying for transfer of providers)

I declare that the information I have provided to the best of my knowledge is true and correct.

I consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice above.

Signature *