Corporate, CEO, and Applicant Information

Primary Corporate Name of Applicant Agency: *
Business License Number (if any)
Website URL *
Corporate Headquarters Address of Applicant Agency
Mailing Address *
City *
State *
Zipcode/Postcode *
Country *	-- Select Country -- AFGHANISTAN ALAND ISLANDS ALBANIA ALGERIA AMERICAN SAMOA ANDORRA ANGOLA ANGUILLA ANTARCTICA ANTIGUA AND BARBUDA ARGENTINA ARMENIA ARUBA AUSTRALIA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BARBADOS BELARUS BELGIUM BELIZE BENIN BERMUDA BHUTAN BOLIVIA BOSNIA AND HERZEGOVINA BOTSWANA BOUVET ISLAND BRAZIL BRITISH INDIAN OCEAN TERRITORY BRUNEI DARUSSALAM BULGARIA BURKINA FASO BURUNDI CAMBODIA CAMEROON CANADA CAPE VERDE CâTE D'IVOIRE CAYMAN ISLANDS CENTRAL AFRICAN REPUBLIC CHAD CHILE CHINA CHRISTMAS ISLAND COCOS (KEELING) ISLANDS COLOMBIA COMOROS CONGO CONGO, THE DEMOCRATIC REPUBLIC OF THE COOK ISLANDS COSTA RICA CROATIA CUBA CYPRUS CZECH REPUBLIC DENMARK DJIBOUTI DOMINICA DOMINICAN REPUBLIC ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ERITREA ESTONIA ETHIOPIA FALKLAND ISLANDS (MALVINAS) FAROE ISLANDS FIJI FINLAND FRANCE FRENCH GUIANA FRENCH POLYNESIA FRENCH SOUTHERN TERRITORIES GABON GAMBIA GEORGIA GERMANY GHANA GIBRALTAR GREECE GREENLAND GRENADA GUADELOUPE GUAM GUATEMALA GUINEA GUINEA-BISSAU GUYANA HAITI HEARD ISLAND AND MCDONALD ISLANDS HOLY SEE (VATICAN CITY STATE) HONDURAS HONG KONG HUNGARY ICELAND INDIA INDONESIA IRAN, ISLAMIC REPUBLIC OF IRAQ IRELAND ISRAEL ITALY JAMAICA JAPAN JORDAN KAZAKHSTAN KENYA KIRIBATI KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF KOREA, REPUBLIC OF KUWAIT KYRGYZSTAN LAO PEOPLE'S DEMOCRATIC REPUBLIC LATVIA LEBANON LESOTHO LIBERIA LIBYAN ARAB JAMAHIRIYA LIECHTENSTEIN LITHUANIA LUXEMBOURG MACAO MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF MADAGASCAR MALAWI MALAYSIA MALDIVES MALI MALTA MARSHALL ISLANDS MARTINIQUE MAURITANIA MAURITIUS MAYOTTE MEXICO MICRONESIA, FEDERATED STATES OF MOLDOVA, REPUBLIC OF MONACO MONGOLIA MONTSERRAT MOROCCO MOZAMBIQUE MYANMAR NAMIBIA NAURU NEPAL NETHERLANDS NETHERLANDS ANTILLES NEW CALEDONIA NEW ZEALAND NICARAGUA NIGER NIGERIA NIUE NORFOLK ISLAND NORTHERN MARIANA ISLANDS NORWAY OMAN PAKISTAN PALAU PALESTINIAN TERRITORY, OCCUPIED PANAMA PAPUA NEW GUINEA PARAGUAY PERU PHILIPPINES PITCAIRN POLAND PORTUGAL PUERTO RICO QATAR REUNION ROMANIA RUSSIAN FEDERATION RWANDA SAINT HELENA SAINT KITTS AND NEVIS SAINT LUCIA SAINT PIERRE AND MIQUELON SAINT VINCENT AND THE GRENADINES SAMOA SAN MARINO SAO TOME AND PRINCIPE SAUDI ARABIA SENEGAL SERBIA AND MONTENEGRO SEYCHELLES SIERRA LEONE SINGAPORE SLOVAKIA SLOVENIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS SPAIN SRI LANKA SUDAN SURINAME SVALBARD AND JAN MAYEN SWAZILAND SWEDEN SWITZERLAND SYRIAN ARAB REPUBLIC TAIWAN, PROVINCE OF CHINA TAJIKISTAN TANZANIA, UNITED REPUBLIC OF THAILAND TIMOR-LESTE TOGO TOKELAU TONGA TRINIDAD AND TOBAGO TUNISIA TURKEY TURKMENISTAN TURKS AND CAICOS ISLANDS TUVALU UGANDA UKRAINE UNITED ARAB EMIRATES UNITED KINGDOM UNITED STATES UNITED STATES MINOR OUTLYING ISLANDS URUGUAY UZBEKISTAN VANUATU VENEZUELA VIETNAM VIRGIN ISLANDS, BRITISH VIRGIN ISLANDS, U.S. WALLIS AND FUTUNA WESTERN SAHARA YEMEN ZAMBIA ZIMBABWE
Phone Number *
Fax Number

A separate signed letter of intent from the CEO is required to accompany this application. This letter should state the rationale for the agency’s interest in AIRC certification, and document that s/he has read the standards, acknowledges the standards, and agrees to the terms and conditions below. You can upload this letter using the file attachment option at the end of this form or fax to +1 (513) 297-7251.

Terms and Conditions

By submitting an application form, the applicant (“Applicant”) hereby agrees to the following:

1. Applicant will provide all information requested by AIRC for purposes of determining whether the application for certification will be accepted and the Applicant allowed to undergo the certification process; assuming acceptance, Applicant will provide all information required for the conduct of its self-evaluation and external review.
2. All information submitted to AIRC by Applicant will be accurate and complete.
3. AIRC may share all information provided by Applicant with AIRC’s employees, officers, directors and any person or entity that assists AIRC with conducting its certification process. Except as otherwise provided in the prior sentence, AIRC will not share with any third party any non-public information (marked “confidential” or “proprietary”) submitted by Applicant to AIRC during the certification process.
4. Applicant will comply with the terms of the AIRC Certification Manual, which AIRC will provide to Applicant and which AIRC may modify from time to time.
5. If Applicant is certified by AIRC, Applicant will comply with all ethical standards and best practices guidelines provided by AIRC regarding the recruitment of international students for American educational institutions.
6. AIRC may terminate Applicant’s certification upon written notice (which may be sent via email) if AIRC’s certification board decides that Applicant is in egregious non-compliance with AIRC’s standards.
7. If AIRC terminates Applicant’s certification, then Applicant will immediately cease (a) representing itself as having AIRC certification; and (b) using any trademark, service mark or logo of AIRC.
8. Applicant will indemnify, defend and hold AIRC, and its directors, members, officers and agents, harmless from and against any claims, losses, damages, liabilities, costs and expenses (including, but not limited to, attorney’s fees) arising out of (a) Applicant’s breach of these Terms and Conditions; and/or (b) AIRC’s efforts to enforce the terms of these Terms and Conditions.
9. Applicant acknowledges that its $2,000 application fee is non-refundable. If Applicant’s application is accepted by AIRC, Applicant will pay AIRC’s standard certification fee to cover AIRC’s certification process. Such certification fee is due upon AIRC’s acceptance of Applicant’s application, and is non-refundable. If AIRC grants certification to Applicant, Applicant will pay AIRC’s standard annual fee, which is due upon certification and annually thereafter. For a schedule of AIRC’s current fee amounts, please click here. All payments made to AIRC will be in U.S. dollars, and will be made by check drawn on a U.S. bank, or by wire transfer in accordance with wire instructions provided by AIRC.
10. If Applicant is certified by AIRC, but fails to pay the annual membership fees for any period of certification following notification of non-payment by AIRC, then Applicant will immediately cease (a) representing itself as having AIRC certification; and (b) using any trademark, service mark or logo of AIRC.
11. These Terms and Conditions will be governed exclusively by the laws of the District of Columbia, United States of America, without reference to the District of Columbia’s choice of law rules. Any suit, action or proceeding seeking to enforce any provision of, or based on any right arising out of, these Terms and Conditions must be brought against either of the parties in the courts of the District of Columbia and each of the parties consents to the jurisdiction of such courts (and of the appropriate appellate courts) in any such suit, action or proceeding and waives any objection to jurisdiction or venue laid therein.

NAME AND ADDRESS OF INDIVIDUAL WHO WILL MANAGE THE CERTIFICATION PROCESS ON BEHALF OF YOUR AGENCY. THIS INDIVIDUAL WILL BE CONSIDERED THE APPLICANT AND WILL BE IN RECEIPT OF ALL CORRESPONDENCE FROM AIRC IN REGARDS TO THE CERTIFICATION PROCESS. IT IS IMPORTANT THAT THIS INDIVIDUAL:

1. Is a senior staff member
2. Is intimately familiar with the nature of the organization
3. Is available to the Certification process, and subsequent AIRC activity, for its duration

Title	- Assoc Dean Assoc Provot Asst Dir Asst VP Adm AVP Enrollm Coord Recruit Dean Adm Dir ESL Dir Int Admis Dir Int Office Director DR Dr. Enrollment m Int Admission Mgr Esl MISS MR Mr. MRS Mrs. MS Ms. PROF Recruitment
Given Name *
Middle Name
Family Name *
Title or Position *
Email Address *
Mailing Address *
City *
State *
Zipcode/Postcode *
Country *	-- Select Country -- AFGHANISTAN ALAND ISLANDS ALBANIA ALGERIA AMERICAN SAMOA ANDORRA ANGOLA ANGUILLA ANTARCTICA ANTIGUA AND BARBUDA ARGENTINA ARMENIA ARUBA AUSTRALIA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BARBADOS BELARUS BELGIUM BELIZE BENIN BERMUDA BHUTAN BOLIVIA BOSNIA AND HERZEGOVINA BOTSWANA BOUVET ISLAND BRAZIL BRITISH INDIAN OCEAN TERRITORY BRUNEI DARUSSALAM BULGARIA BURKINA FASO BURUNDI CAMBODIA CAMEROON CANADA CAPE VERDE CâTE D'IVOIRE CAYMAN ISLANDS CENTRAL AFRICAN REPUBLIC CHAD CHILE CHINA CHRISTMAS ISLAND COCOS (KEELING) ISLANDS COLOMBIA COMOROS CONGO CONGO, THE DEMOCRATIC REPUBLIC OF THE COOK ISLANDS COSTA RICA CROATIA CUBA CYPRUS CZECH REPUBLIC DENMARK DJIBOUTI DOMINICA DOMINICAN REPUBLIC ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ERITREA ESTONIA ETHIOPIA FALKLAND ISLANDS (MALVINAS) FAROE ISLANDS FIJI FINLAND FRANCE FRENCH GUIANA FRENCH POLYNESIA FRENCH SOUTHERN TERRITORIES GABON GAMBIA GEORGIA GERMANY GHANA GIBRALTAR GREECE GREENLAND GRENADA GUADELOUPE GUAM GUATEMALA GUINEA GUINEA-BISSAU GUYANA HAITI HEARD ISLAND AND MCDONALD ISLANDS HOLY SEE (VATICAN CITY STATE) HONDURAS HONG KONG HUNGARY ICELAND INDIA INDONESIA IRAN, ISLAMIC REPUBLIC OF IRAQ IRELAND ISRAEL ITALY JAMAICA JAPAN JORDAN KAZAKHSTAN KENYA KIRIBATI KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF KOREA, REPUBLIC OF KUWAIT KYRGYZSTAN LAO PEOPLE'S DEMOCRATIC REPUBLIC LATVIA LEBANON LESOTHO LIBERIA LIBYAN ARAB JAMAHIRIYA LIECHTENSTEIN LITHUANIA LUXEMBOURG MACAO MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF MADAGASCAR MALAWI MALAYSIA MALDIVES MALI MALTA MARSHALL ISLANDS MARTINIQUE MAURITANIA MAURITIUS MAYOTTE MEXICO MICRONESIA, FEDERATED STATES OF MOLDOVA, REPUBLIC OF MONACO MONGOLIA MONTSERRAT MOROCCO MOZAMBIQUE MYANMAR NAMIBIA NAURU NEPAL NETHERLANDS NETHERLANDS ANTILLES NEW CALEDONIA NEW ZEALAND NICARAGUA NIGER NIGERIA NIUE NORFOLK ISLAND NORTHERN MARIANA ISLANDS NORWAY OMAN PAKISTAN PALAU PALESTINIAN TERRITORY, OCCUPIED PANAMA PAPUA NEW GUINEA PARAGUAY PERU PHILIPPINES PITCAIRN POLAND PORTUGAL PUERTO RICO QATAR REUNION ROMANIA RUSSIAN FEDERATION RWANDA SAINT HELENA SAINT KITTS AND NEVIS SAINT LUCIA SAINT PIERRE AND MIQUELON SAINT VINCENT AND THE GRENADINES SAMOA SAN MARINO SAO TOME AND PRINCIPE SAUDI ARABIA SENEGAL SERBIA AND MONTENEGRO SEYCHELLES SIERRA LEONE SINGAPORE SLOVAKIA SLOVENIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS SPAIN SRI LANKA SUDAN SURINAME SVALBARD AND JAN MAYEN SWAZILAND SWEDEN SWITZERLAND SYRIAN ARAB REPUBLIC TAIWAN, PROVINCE OF CHINA TAJIKISTAN TANZANIA, UNITED REPUBLIC OF THAILAND TIMOR-LESTE TOGO TOKELAU TONGA TRINIDAD AND TOBAGO TUNISIA TURKEY TURKMENISTAN TURKS AND CAICOS ISLANDS TUVALU UGANDA UKRAINE UNITED ARAB EMIRATES UNITED KINGDOM UNITED STATES UNITED STATES MINOR OUTLYING ISLANDS URUGUAY UZBEKISTAN VANUATU VENEZUELA VIETNAM VIRGIN ISLANDS, BRITISH VIRGIN ISLANDS, U.S. WALLIS AND FUTUNA WESTERN SAHARA YEMEN ZAMBIA ZIMBABWE
Phone Number *
Fax Number
Cell Phone Number
DOB (Date of Birth)
If an individual OTHER than the CEO or Certification Manager listed above completed this application please complete the following section.
Given Name of Person Completing Form
Family Name of Person Completing Form
Position or Title of Person Completing Form
Email of Person Completing Form
Cell of Person Completing Form

Use the boxes below to list all countries from which your agency targeted students for recruitment in the most recent year.

Country	Branch Manager	Phone	No. of Students Placed

If your agency currently recruits students for accredited American postsecondary institutions on a contractual basis (with a fee or commission paid by the institution) please list all of those U.S. clients and the additional contact information requested in the boxes below.

U.S. Educational Institution	Name of Primary Contact	Email	Phone

Aside from the United States, for what other post-secondary systems does your agency recruit students?

Check all that apply and list 3 institutional references per country.

United Kingdom     Australia     Canada     Other (list)

United Kingdom	Institution 1 Institution 2 Institution 3
Australia	Institution 1 Institution 2 Institution 3
Canada	Institution 1 Institution 2 Institution 3
Other (Please list):
Institution 1
Institution 2
Institution 3
Has your agency been a party to any civil or criminal proceedings in the past five (5) years either domestically or internationally? If yes, please describe fully: the specific circumstances (cite date(s) of public reference); the legal outcome (cite date(s) of public reference); what your agency did in response to the charge; and what measures your agency has taken to prevent a recurrence. Is your agency in compliance with all local laws and regulations governing your industry?   If not please provide an explanation as why it is not in compliance. You may also use this box for any general comments or remaining questions you may have.
Comments/Enquiries
Attach File(s) (e.g. Letter of Intent, Lists of Offices if over 30, etc.)	Note: 100MB limit; if you have multiple files to upload, use Zip to compress them first. Download the free WinZip software.