sac-register-wpform – IEG Campus

Company Details

Business Name

Business Registration / Licence Number

Name of Governing Authority issuing Registration / Licence

State of Territory of Registration

Date of Registration & Validity

Date of Last Audit / Review

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Body Corporate

Principle place of business

Does the company / provider plan to gain registration

Company to Execute: Describe fully the nature of the authority of the person signing and authorising this Due Diligence. What is the nature of this authority, which may be required for perusal?

Please provide details of any engagements, obligations or commitments that the Company/Provider or any of its partners, staff or consultants have or are likely to acquire which may give rise to any actual or perceived conflict or interest with any of the services that may be required in connection with the proposed contract.

Please advise of details of any strategy for identifying, managing and preventing conflicts of interest.

Website

The Provider promises that it, and its partners, staff and consultants, do not have and are not aware of any actual or potential conflicts of interest which may arise between IEG Campus and the Company/ Provider unless indicated below.

Printed Name

Title

Bank and Finance Details

I do not wish to provide bank details at this time

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Referee

Name of referee

Company of referee

Referee Country

Phone

Facsimile

Email of referee

Description of service provided

Second Referee

Name of second referee

Company of second referee

Second referee Country (copy)

Second referee Phone

Second referee Facsimile (copy)

Email of second referee

Description of service provided

Expertise and Experience

Specific expertise in education/training/consulting: Briefly detail recent experience in delivering educational/training courses/ consultancy services. IEG Campus desires to obtain succinct and relevant information. The reason why each activity is relevant is required.

Knowledge of the industry and market: Provide details of your organisation’s knowledge and experience as an educational/training/consultancy service provider, in particular, as it applies to the type of work expected under this contract.

Strategic: Briefly detail how you will market the educational/training/consultancy services. IEG Campus desires to obtain succinct and relevant information. The reason why each activity is relevant is required.

Key Staff:

Briefly introduce key academic and operational staff (please attach a resume copy for each listed).

Position Title

Name

Qualifications

Bio

Facilities

Briefly detail what student facilities will be available to students on your premises? IEG Campus desires to obtain succinct and relevant information.

IEG Campus Study Abroad Centre Student Support Office and Learning Room.

An IEG Campus Study Abroad Centre will require the Company / Provider to provide a dedicated room/working space for student support service at its premise which will be labelled as indicated in the IEG Campus Brand Book. Kindly provide details and floor plan / image for the above requirement.

Office Image

Click or drag a file to this area to upload.

You can upload 1 file. If many kindly please zip it and upload it.

Education Services for Overseas Students (ESOS) Compliance or Similar in your country of operation:

Following any Re-registration or external ESOS audits held at your organisation’s teaching/training locations were there any major non-compliant issues raised in your reports? Definition of major non-compliant issue: Issue that could result in your organisation losing Service Provider Registration or equivalent in your country of operation.