ECA Change of Agent

Request Form

INSTRUCTIONS
Complete and sign this form, and submit it to Education Centre of Australia with a signed Education Centre of Australia
Agency Agreement to Represent Form signed by the preferred new Agent.

You may submit the forms in hard copy or via email.

Family Name: KAUR

Given Name: SANAMPREET
Student n : o
3287907 DOB: 03/08/2004
Course: BACHELOR OF EARLY CHILDHOOD EDUCATION (BIRTH TO FIVE) (EDB001)
Present Agent: 3287907

Reason(s) for Change of Agent

• If your present Agent agrees to the transfer please attach a Release Letter from your existing Agent to this
Application.
• If you are making a Complaint about your existing Agent please complete and submit an Education Centre of
Australia Student Complaint Form with this Application.

I AM NOT SATISFIED WITH CURRENT AGENT SERVICES

Preferred new Agent (Selected from the list of Authorised Partners on the Education Centre of Australia Website)

Agency Company: UNIXPLORE

Agent’s name: KARAN
Agent’s Phone: +919928012521 email: karan@unixplore.com.au

Attached documents:
• Release Letter from present Agent YES / NO
• Education Centre of Australia Student Complaint Form (about your present Agent) YES / NO
• Agency Agreement to Represent Form from preferred new Agent YES / NO

Signature: ................................................................ Date: ................................

On receipt of the completed forms Education Centre of Australia will consider your application and inform you of the
outcome within ten days of receiving the Application. If your application is approved your agent representation details
will be changed in the Education Centre of Australia Agent Database.

NOTE: This Application will be considered and processed in accordance with Education Centre of Australia’s Policy
and procedure on Change of Agents.

EDUCATION CENTRE OF AUSTRALIA - Level 10, 160 - 166 Sussex St - Sydney 2000 NSW - Tel: (02) 8265-3200 - email:info@eca.edu.au | CRICOS Provider Code: 02644C