Agent Applicant's Information

Please note that a formal agent agreement will only be pursued once an agent has demonstrated she/he is able to register a minimum of ten (10) individuals within a twelve (12) month period. No commission will be paid until an agent has met that threshold.
This application form collects private information about you so that we can determine the types of services/supports required.
Company Name
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Address
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City
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Postal/Zip Code
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  • Nigeria
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  • Syrian Arab Republic
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  • Timor-Leste
  • Togo
  • Tokelau
  • Tonga
  • Trinidad and Tobago
  • Tunisia
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  • Turkmenistan
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  • Ukraine
  • United Arab Emirates
  • United Kingdom of Great Britain and Northern Ireland
  • United Republic of Tanzania
  • United States of America
  • Uruguay
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  • Vanuatu
  • Venezuela (Bolivarian Republic of)
  • Viet Nam
  • Yemen
  • Zambia
  • Zimbabwe
- select a country -
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Company Website
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Primary Contact Information

First Name
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Contact Position
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Contact Email
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Last Name
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Contact Phone
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Contact Email Confirmation
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Historical Information

Provide a brief history of your agency
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Has the company or any individual within the company ever been involved in past, pending, threatened or potential litigation, arbitration, administrative actions or other disputes?
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Does the company currently have or is the company expecting to have permanent staff residing in Canada who will provide direct service and support to your students?
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Primary Geographic Focus
  • - select a country -
  • Afghanistan
  • Albania
  • Algeria
  • Andorra
  • Angola
  • Antigua and Barbuda
  • Argentina
  • Armenia
  • Australia
  • Austria
  • Azerbaijan
  • Bahamas
  • Bahrain
  • Bangladesh
  • Barbados
  • Belarus
  • Belgium
  • Belize
  • Benin
  • Bhutan
  • Bolivia (Plurinational State of)
  • Bosnia and Herzegovina
  • Botswana
  • Brazil
  • Brunei Darussalam
  • Bulgaria
  • Burkina Faso
  • Burundi
  • Cabo Verde
  • Cambodia
  • Cameroon
  • Canada
  • Central African Republic
  • Chad
  • Chile
  • China
  • Colombia
  • Comoros
  • Congo
  • Cook Islands
  • Costa Rica
  • Croatia
  • Cuba
  • Cyprus
  • Czechia
  • Democratic People's Republic of Korea
  • Democratic Republic of the Congo
  • Denmark
  • Djibouti
  • Dominica
  • Dominican Republic
  • Ecuador
  • Egypt
  • El Salvador
  • Equatorial Guinea
  • Eritrea
  • Estonia
  • Eswatini
  • Ethiopia
  • Faroe Islands
  • Fiji
  • Finland
  • France
  • Gabon
  • Gambia
  • Georgia
  • Germany
  • Ghana
  • Greece
  • Grenada
  • Guatemala
  • Guinea
  • Guinea-Bissau
  • Guyana
  • Haiti
  • Honduras
  • Hungary
  • Iceland
  • India
  • Indonesia
  • Iran (Islamic Republic of)
  • Iraq
  • Ireland
  • Israel
  • Italy
  • Jamaica
  • Japan
  • Jordan
  • Kazakhstan
  • Kenya
  • Kiribati
  • Kuwait
  • Kyrgyzstan
  • Lao People's Democratic Republic
  • Latvia
  • Lebanon
  • Lesotho
  • Liberia
  • Libya
  • Lithuania
  • Luxembourg
  • Madagascar
  • Malawi
  • Malaysia
  • Maldives
  • Mali
  • Malta
  • Marshall Islands
  • Mauritania
  • Mauritius
  • Mexico
  • Micronesia (Federated States of)
  • Monaco
  • Mongolia
  • Montenegro
  • Morocco
  • Mozambique
  • Myanmar
  • Namibia
  • Nauru
  • Nepal
  • Netherlands
  • New Zealand
  • Nicaragua
  • Niger
  • Nigeria
  • Niue
  • North Macedonia
  • Norway
  • Oman
  • Pakistan
  • Palau
  • Panama
  • Papua New Guinea
  • Paraguay
  • Peru
  • Philippines
  • Poland
  • Portugal
  • Qatar
  • Republic of Korea
  • Republic of Moldova
  • Romania
  • Russian Federation
  • Rwanda
  • Saint Kitts and Nevis
  • Saint Lucia
  • Saint Vincent and the Grenadines
  • Samoa
  • San Marino
  • Sao Tome and Principe
  • Saudi Arabia
  • Senegal
  • Serbia
  • Seychelles
  • Sierra Leone
  • Singapore
  • Slovakia
  • Slovenia
  • Solomon Islands
  • Somalia
  • South Africa
  • South Sudan
  • Spain
  • Sri Lanka
  • Sudan
  • Suriname
  • Sweden
  • Switzerland
  • Syrian Arab Republic
  • Tajikistan
  • Thailand
  • Timor-Leste
  • Togo
  • Tokelau
  • Tonga
  • Trinidad and Tobago
  • Tunisia
  • Turkey
  • Turkmenistan
  • Tuvalu
  • Uganda
  • Ukraine
  • United Arab Emirates
  • United Kingdom of Great Britain and Northern Ireland
  • United Republic of Tanzania
  • United States of America
  • Uruguay
  • Uzbekistan
  • Vanuatu
  • Venezuela (Bolivarian Republic of)
  • Viet Nam
  • Yemen
  • Zambia
  • Zimbabwe
- select a country -
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Agent Motivation

Briefly explain why an agent agreement with us is important:
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Briefly explain why an agent agreement with us is important:

Reference #1 (Canadian School, College or University Representative)
Contact Name
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Contact Position
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Name of Institution
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Contact City
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Declaration of Intent and Accuracy

If approved as an agent for cotalks Inc. I am committed to representing the company in an honest, ethical and professional manner.
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Submit