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					         THIRD-PARTY RECRUITER/ AGENCY QUESTIONNAIRE

1. Please give the exact official name, address, and telephone number of your agency.
   If offices are located in multiple cities, please list the primary contact address or main office of the
   company.

   English
   Name:
   Address:


   Telephone:
   Fax:
   English Website:

   Native Language
   Name:
   Address:


   Telephone:
   Fax:
   Native Language Website:


2. Does your company hold certification or licensing to act as a consulting agency?
      a. If so, who issued the certificate or license? Please provide a copy with this Questionnaire.


3. Does your company have a Profile?
      a. If so, please provide a copy with this Questionnaire.


4. If your company holds offices in multiple cities, please list the cities of the other offices:
5. Please list the names and titles of officers of the agency.




6. Which person would be listed on the contract (name and title)?



7. How many staff members do you have?

           Part-time:             Full-time:


8. How many have been educated in the United States? :

           U.S. undergraduate degree:
           U.S. graduate degree:
           U.S. non-degree study :
           Non-U.S. degree:


9. Does your organization have contractual relationships with other placement or counseling
   organizations?

           Yes             No


10. Do you obtain admission for students at institutions other than those which you have a contractual
    agreement?

           Yes             No

11. If your agency uses other names or has used other names in the past, please list them.



12. What services are provided to the student? (check all that are applicable)
    ____ Placement (seeking admission to University on behalf of prospective students)
    ____ Recruitment (seeking to attract students to particular institutions or programs)
    ____ Advising/counseling
    ____ Publications/Advertising
    ____ Travel arrangements including flight or hotel reservations
    ____ Offering ESL
    ____ Job placement
    ____ U.S. educational resource library
    ____ Test preparation (Please list which tests):
    ____ Official Test site (Please list which tests):
13. When did your agency begin operation?


14. In which countries (including the U.S.) do you promote your services?


15. In what type of academic programs do you seek admission for student?

           _____ Secondary Schools
           _____ Short-term
           _____ Two year Colleges
           _____ Four-year Universities
           _____ Public
           _____ Private
           _____ ESL programs
           _____ Other:


16. How many students were admitted to U.S. Schools through your services in the last twelve months?



17. From which countries did these students (question 15) come?



18. Please check which types of fees charged to the students/families (answers to this question does not
    impact the commission paid to agents)

           ____   Fee for ESL and/or English Testing preparation
           ____   Fee for counseling/advising
           ____   Fee for admission obtained
           ____   Fee for visa help
           ____   Fee for successfully receiving a visa
           ____   Other:


19. Does your agency have permission to make forms DS-2019 or for I-20 in SEVIS?

           Yes____        No____


20. In any contractual agreements with colleges and universities, does your agency have the authority to
    make admission commitments to students (generating the official admission decision on behalf of the
    college or university)?

           Yes____        No____
   21. How does your office verify the accuracy/authenticity of a student’s academic records?



   22. Does your company offer any pre-departure orientation for students before they come to the United
       States?

              Yes____        No____

                     If so, what do you teach them?



   23. Please list 3 References.
               NOTE: Three references must be listed in order to be considered for partnership. If one cannot
                        be reached, you will be expected to provide an additional reference. If you cannot
                        provide three references, a contract will not be offered to your agency.

      1. Contact Name:
         Contact’s Title:
         University:
         Address:
         Phone Number:
         Email Address:

      2. Contact Name:
         Contact’s Title:
         University:
         Address:
         Phone Number:
         Email Address:

      3. Contact Name:
         Contact’s Title:
         University:
         Address:
         Phone Number:
         Email Address:



REMINDER: Please send a copy of the Business License and Company Profile with this questionnaire.
Questionnaire completed by:

Name:
Title:
E-mail:
Date:



Thank you for fill out the questionnaire for the University of Wisconsin-Green Bay. Please return this
questionnaire to (email preferable):

Molly Witt
Nonresident & International Recruiter
Office of Admissions
University of Wisconsin-Green Bay
2420 Nicolet Drive
Green Bay, WI 54311

Phone: 920-465-2111
Text: 920-360-3825
Fax: 920-465-5754
Email: wittm@uwgb.edu

				
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posted:12/12/2011
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