Agent Registration

Section A: Personal Details

Type of Application *

New Renew

Passport Size Photo *

Click to upload photo PNG, JPEG (Max 2MB)

Company Name / Individual Name *

Registration / NRIC / Passport No. *

Correspondence Address *

Postal Code *

Country *

Section B: Contact Information

Contact Person Name *

Designation *

Telephone (Office) *

Fax

Mobile Phone *

Email Address *

Website Address

Section C: Experience Details

The countries you cover:

Have you / Has your company ever been appointed as a recruitment agent by other educational institutions?

Yes No

Section D: Bank Account Details

Account Name:
Account No.:
Bank Name:
Bank Branch:
Swift Code:
Bank Address:

Section E: Agreement & Declaration

SIGNEE OF AGREEMENT	WITNESS OF AGREEMENT
Full Name:	Full Name:
Designation:	Designation:
NRIC/Passport:	NRIC/Passport:

DECLARATION
I hereby declare that the information provided is true and valid, with the understanding that UPTM reserves the right to withdraw the offer if the information is untrue and invalid. UPTM complies with the Personal Data Protection Act (PDPA) in handling and safeguarding your personal information.
I confirm the above declaration is true Date:

DECLARATION

I hereby declare that the information provided is true and valid, with the understanding that UPTM reserves the right to withdraw the offer if the information is untrue and invalid.

UPTM complies with the Personal Data Protection Act (PDPA) in handling and safeguarding your personal information.

I confirm the above declaration is true

Date:

Section F: Documents Upload

APPLICATION CHECKLIST (please submit certified true copies of the following documents)

Select Agent Type:

Corporate Agent Individual Agent

Important:

Only PDF, DOC, DOCX, JPG, JPEG, and PNG files are allowed
Maximum file size is 5MB per document
Ensure all documents are clear and legible

INTERNATIONAL STUDENT RECRUITMENT AGENT APPLICATION FORM