APPLICATION TO BECOME A William Academy’S PARTNER-IMMIGRATION SERVICE COMPANY Please fill in the information below. ( required * ) William Academy respects your privacy. We will not sell or trade the information that you enter into this form. First Name :* Last Name :* Address :* City:* Province:* Postcode:* Your Country:* Phone Number:* Fax: Email :* Contact Information In Canada: Contact in canada: Address: City: Province: Postcode: Country: Phone Number: Fax: Email : What Canadian school boards or high schools do you currently represent? : Number of students you sent to Canada during the past two years? : Please list any memberships in industry-related associations or organizations: : Is there any other information you would like to provide us about your company? :