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Request for Authorization


Please complete the following authorization form. Please complete all sections.
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Contact information (please complete ALL fields)
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Registered name of organization
Operating name if different
Name of contact person
Position
Main E-mail address
Secondary E-mail address
Full postal address
Telephone number
(include country and area codes)
Fax number
(include country and area codes)
Country
Your web page address
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If the above information does not refer to your head office, please enter head office details below. If the information is the same, please leave blank.
Registered name of organization
Operating name if different
Full postal address
Telephone number
 (include country and area codes)
Fax number
 (include country and area codes)
Country
Your web page address
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Business Background
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Years in business as an education agent
No. of students recruited for study each year
No. of students for study in Japan in the last 24 months
No. of students for Shugaku visa in the last 24 months
No. of students for Ryugaku visa in the last 24 months
Which schools in Japan have you sent students to?
(please list all schools and cities)
Do you invoice any separate fees to the student
(eg student service fee/finders fee)
If yes, how much do you invoice each student?
Services provided to students
(check all applicable)


If other, please specify
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Staff Background
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Number of staff in your company
Number of counsellers in your company
Qualifications
How many of these staff have studied or worked in Japan?
How many of your staff can read and write Japanese?
Reasons for wanting to represent The Yamasa Institute
How did you find out about The Yamasa Institute
If other, please give details
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Clients
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What is the average age of your clients
How long do they usually want to visit Japan
Do they usually have family/friends in Japan
Have you tried to apply for visas for your clients to visit Japan in the past
What is the success rate for your student visa (shugaku/ryugaku) applications
What is the main reason for your clients' studyabroad
What do your clients consider important when choosing a school
What do you consider important
How do you find most of your clients (please check as many as apply)



If other, please specify
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Referees (These can be other schools in Japan or abroad that you represent, or accreditation bodies of which you are a member)
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Referee 1
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Company name
Contact name
Position
Address
Telephone number
Facsimile number
Email
Homepage
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Referee 2
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Company name
Contact name
Position
Address
Telephone number
Facsimile number
Email
Homepage
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Thank you for taking the time to complete this form. We will process your application and contact you within the next three weeks.
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