Recruitment Partner Application

Thank you for your interest in partnering with Shoreline Community College. Please fill out and submit the application below. After receiving it, we will contact you as soon as possible. If you have any questions about the application, please contact


Agency/Company Information
Agency Name*
Street Address*


State or Province*

Postal Code*
(Country code, City code, Number)                             Fax

What country will most of your students come from?

Email address (

Email address (type again for confirmation)*


President or Director

First/Given Name*
                                         Surname/Family Name* 
(Country code, City code, Number)                   Fax
Email address*

Main Contact Person
Check the box if same as above


First/Given Name
                                         Surname/Family Name 
(Country code, City code, Number)                  Fax
Email address
General Information
What year was your company established?

How many students did you send to the USA during the past year?

What percent of your students are interested in the following programs?
%   1-year certificate
%   2-year professional/technical degree
%   2-year university transfer
%   High school completion + university transfer

Do you or your company have a government license?
yes no             Please fax (206-546-7854) or email a copy to Samira Pardanani.

Are you or your agency a member of any professional association?                
yes no       Association Name

Have you or your agency ever received an award or recognition from the government or another organization?                
yes no              Award Name

Is your agency already working with other community colleges in Washington or other states?             
yes no      
If so, please indicate which ones:

Optional: please describe any special features of your agency. What makes it special or different from others?  You may also fax or email a company profile to  Samira Pardanani (206-546-7854).

How did you hear about Shoreline Community College?

We have some basic expectations of all our Recruitment Partners. For example, our Partners should:

-answer all of the student's admissions related questions
-provide pre-departure orientation
-provide information/assistance with applying for a student visa
-provide all of a student's application materials directly to our Office

Please indicate if these services are already part of your typical service.
yes no

Have you, your agency, or any employee of the agency ever been involved in a past or pending legal dispute related to educational advising?
yes no

If yes, please explain:



Please list references you may have from another institution. Though we prefer to have references, we will still consider your application if none are available.

First/Given Name                                           Surname/Family Name 


Company or School name

(Country code, City code, Number)                   Fax
Email address

First/Given Name                                           Surname/Family Name 


Company or School name
(Country code, City code, Number)                 Fax
Email address
Digital Signature
I certify that the information provided above is correct. I understand that Shoreline Community College may terminate its relationship with me, my agency or any associated representatives if the College has reason  to believe that any of this information is false.