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Step
1
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2
50%
Agency/Company Information
Agency Name
*
Address
*
Street Address
Address Line 2
City
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
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Australia
Austria
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Bonaire, Sint Eustatius and Saba
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Chad
Chile
China
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Congo, Democratic Republic of the
Cook Islands
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Germany
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Guinea-Bissau
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Korea, Republic of
Kuwait
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Panama
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Virgin Islands, U.S.
Wallis and Futuna
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Åland Islands
Country
Phone
*
(Country code, City code, Number)
What country will most of your students come from?
*
Email Address (from)
*
Enter Email
Confirm Email
Website
*
President or Director
Title
*
Name
*
First/Given Name
Surname/Family Name
Phone
*
(Country code, City code, Number)
Email
*
Main Contact Person
Same as Above?
*
Yes
No
Title
Name
First/Given Name
Surname/Family Name
Phone
(Country code, City code, Number)
Email
General Information
What year was your company established?
How many students did you send to the USA during the past year?
*
What percentage of your students are interested in a Bachelor's Degree?
*
What percentage of your students are interested in a Master's Degree?
*
What percentage of your students are interested in a Doctorate Degree?
*
Does your company have a government license?
*
Yes
No
Are you are your agency a member of any professional association?
*
Yes
No
If yes, please list association name(s).
Have you or your agency ever received an award or recognition from the government or another organization?
*
Yes
No
If yes, please list award name(s).
Is your agency already working with other universities in Texas or other states?
*
Yes
No
If yes, please indicate which universities.
Optional: Please describe any special features of your agency. What makes it special or different from others?
How did you hear about Houston Christian University?
*
We have some basic expectations of all our Recruitment Partners. For example, our Partners should:
• Answer all of the student’s admissions related questions
• Provide pre-departure orientation
• Provide information/assistance with applying for a student visa
• Provide all of a student’s application materials directly to HCU Admissions
Please indicate if the above services are already part of your typical service:
*
Yes
No
If yes, please explain:
References
Please list references you may have from another institution.
Reference #1
Name
First/Given Name
Surname/Family Name
Title
Company or School Name
Phone
(Country Code, City Code, Number)
Email
Reference #2
Name
First/Given Name
Surname/Family Name
Title
Company or School Name
Phone
(Country Code, City Code, Number)
Email
Confirmation
*
I certify that the information provided above is correct. I understand that Houston Christian University may terminate its relationship with me, my agency, or any associated representatives for any reason and at any time.
Yes
Digital Signature
*
Title, Name, Date
