background 0background 1background 2background 3

The CSU has a new policy on freedom of expression. Learn more.

Breadcrumb

Humboldt Agent Questionnaire

hank you for your interest in representing Cal Poly Humboldt. We are seeking qualified and reputable representatives in countries who may represent our university internationally. We are committed to providing timely communication and assistance to our partner representatives.

We would like to get to know your organization by asking a few questions so that we may be able to determine if your services are compatible with us. Thank you in advance for your time in filling out this questionnaire.

Include street address, city, state/province, country, and postal code.
If different from mailing address.

Owner/Manager Information

e.g. Owner, Director, Manager
Will this person be signing the contract/agreement?
Include street address, city, state/province, country, and postal code.

Primary Contact for Cal Poly Humboldt

Agency History

Does your agency charge students a service fee?

References

Please provide us with information for three U.S. institutions, with names and contact information of individuals that we may contact for reference. If US references are not available, please provide contacts for Australia and/or Canada and/or the UK.
Name (Last, First) of University Representative:
Name of University:
Email:
Name (Last, First) of University Representative:
Name of University:
Email:
Name (Last, First) of University Representative:
Name of University:
Email: