New Agency Contact Form

Recruitment Partner Application

Thank you for your interest in partnering with Shoreline Community College. Please fill out and submit the application below. After receiving it, we will contact you as soon as possible. If you have any questions about the application, please contact IEoutreach@shoreline.edu

Agency Name

Is this a Branch Office?

Yes

What is the Name of the Parent Agency?

Agency Address

Country

Street

City

Region

Postal Code

Agency Website

Agency Phone Number

Agency Email Address

From which country/countries do most of your students hold passports from?

Add Another Country?

Yes

Student Country 2 - Optional

Student Country 3 - Optional

Student Country 4 - Optional

President or Director

President or Director First / Given Name

President or Director Surname / Family Name

President or Director Preferred or English Name

President or Director Title

President or Director Phone

President or Director Email Address

President or Director: Would you like to Share your Social Media Information?

Yes

What type of social media would you like us to use?

Social Media Contact Information

Is the Main Contact Person the same as above?

Yes

Main Contact

Main Contact First / Given Name

Main Contact Last Name

Main Contact Preferred or English Name

Main Contact Title

Do you have an email address that is different than the agency email address?

Yes

Main Contact Email Address

Main Contact Phone

Would you like to share your social media information?

Yes

What type of social media would you like to use?

What is your social media information?

General Information

What year was your company established?

What percent of your students are interested in the following programs?

One-Year Certificate

Two-Year Professional / Technical Degree

Two-Year University Transfer

High School Completion and University Transfer

Is your agency a member of any professional associations?

Yes

Association Name

Association Name 2 - Optional

Association Name 3 - Optional

Association Name 4 - Optional

Has your agency ever received an award or recognition from the government or another organization?

Yes

Award Name

Is your agency already working with other community colleges in Washington or other states in the U.S.?

Yes

Please indicate which other community colleges you are working with.

Working with Another Community College? 2 - Optional

Working with Another Community College? 3 - Optional

Working with Another Community College? 4 - Optional

Optional: please describe any special features of your agency. What makes it special or different from others?

If you would like to provide a company profile, you may upload it here.

How did you hear about Shoreline Community College?

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 our office

Are these services currently part of your typical service?

Yes

Have you, your agency, or any employee of the agency, ever been involved in a past / pending legal dispute related to educational advising?

Yes

Please explain any involvement concerning the past or pending legal dispute.

References

Please list references you may have from other institutions. At least one reference is required.

Reference First / Given Name

Reference Surname / Family Name

Reference Title

Reference Company or School Name

Reference Phone

Reference Email

2nd Reference First / Given Name

2nd Reference Surname / Family Name

2nd Reference Title

2nd Reference Company or School Name

2nd Reference Phone

2nd Reference Email

I certify that the information provided above is correct. I understand that Shoreline Community College may terminate its relationship with me, my agency or any associated representatives if the College has reason to believe that any of this information is false. *

By typing my signature below, I certify that I agree with the statement above.

Signature