Agency Application

This application form must be completed entirely.  If your organization has more than one location, you must apply for each location separately.  For each location, there must be one unique e-mail address as an administrator to manage each account.  If you are interested in managing all accounts of multiple offices with different addresses with a single e-mail address, please provide different location information in the note section of this application form.

Upon submission of this application form, you will be informed within 10 days whether your application is accepted or not.  If your application is accepted, you may add other users in AIS (Agency Information System) so that they have an access to the system facilitating their working with POLY Languages Institute.

Thank you very much for your interest in working with POLY Languages Institute.

Company  *
Address
City
Province / Territory
Postal Code
Country  *
Tel  *
Fax
Homepage
Note
Title
First Name   *
Last Name   *
Position Title   *
E-mail   *
Password   * 
Confirm Password   *
1) Does your agency possess all applicable permits and licenses to conduct business in the said premise stated herein?
       
2) Please, indicate the most common age group of your clients.
                 
3) On the average, how many students do you anticipate to recruit for POLY every two months?   
4) Briefly describe your organization such as the year established, the size (number of staff), the type of services provided, etc.
   
5) What features are important to your agency when working with a language school?
   
6) Please tell us at least three language schools in the U.S.  that you have agreements with.
   
7) Please let us know how you heard about us and why you are choosing to work with us?
   

Agreement and Testament

The company stated herein is a bona fide agency which assists and consults its clients to study English as a Second Language/Test Preparation programs in the United States.  The company has all applicable licenses and permits to conduct business in the said premise as submitted to POLY Languages Institute, Inc., hereafter POLY.  With the due diligence, the company promises to train its staff to accurately inform its clients about the school's program, policies and procedures.

I, on behalf of the company by checking the box below, certify that all the statements herein is true and agree to all the terms and agreements of POLY.  I understand that the company stated herein and POLY are entering at will agreement where POLY has the right to terminate any agreements at anytime for any reason with a written notice.  I also understand that any dispute or legal claim shall be resolved under the U.S. law in the city of Los Angeles, California.