Agent Registration Form

Britannia English Academy Agent Questionnaire

To apply to become an authorised agent for Britannia English Academy please complete this form.

After you complete it we will contact you to finalise our agreement and then we can begin to work together.

Your Contact Details


Full Name: (required)

Job Title:

Company Name: (required)

Company Address:

Email: (required)

Website: (required)

Telephone: (required)


Your Organisation

How many offices/branches does your agency have?: (required)

Which countries do you recruit students from?: (required)

More or less how many students does your agency send abroad each year?: (required)

And about how many do you send to the UK?: *: (required)

And about how many do you send to Ireland?: (required)

If you send students to the UK, do they mainly go to London or places outside London?: (required)

Which are your favourite destinations?: (required)
AustraliaCanadaNew ZealandUnited StatesMaltaIrelandUKOthers

Which agent associations do you belong to?:


Which schools/colleges/universities in UK do you currently work with?: (required)

Can we contact them for a reference?: (required)

If 'No', Why Not?:

Please provide us with the contact details (email, telephone) of two UK institutions you currently work with.:

Working with Britannia English Academy

How did you first hear about Britannia English Academy?: (required)

If 'Other' please provide details:

How many students can you send to Britannia English Academy per year?:

Which English programmes are you most interested in?: (required)
General EnglishIELTSCambridge Exams (FCE/CAE)Business EnglishTOEICAdultsChildrenAll YearSummerOther

If 'Other' please provide details:

Do you produce your own brochure?: (required)

How will you promote Britannia English Academy?: (required)

When are you next visiting the UK?: (required)

The value must be in YYYY-MM-DD format (e.g. 2015-04-15)

What do you expect from Britannia English Academy?: (required)

Do you need any more information from Britannia English Academy?: (required)


Do any of your students need visas to enter the UK or Ireland?: (required)

Are UK GSVs important to you, or do you not care?: (required)

Do you understand the rules about UK visas or do you want more training?: (required)

Terms of Business

What percentage commission do you expect?: (required)

How do you prefer to get paid?: (required)


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