Note: Please Fill All The Columns.                                                          If you Just Want to Enquire Click here
Name of organization		Address for correspondence
Contact person		Country
Position in the organization		Telephone No
Email address		Fax No
In which country/ies do you wish to assist chinambbs.com in its recruitment campaign? (please specify cities)		Website
ABOUT YOUR ORGANIZATION (please circle)
Are you officially licensed to operate as an agent by local law?If yes, please attach evidence.	YesNo
Is your company or part thereof, known under any other name? If yes, what other trading names does your company have?	YesNo
Do you currently represent any institutions in China If yes, please list the names of these institutions.	YesNo
Please attach brief curriculum vitae for the members of your staff involved in counseling for chinambbs.com
ABOUT YOUR SERVICE AND FACILITIES
Do you represent Higher Education institutions in other countries? If yes, please list the institutions and the approximate number of students referred in 2005.	YesNo
Do your premises comprise a consultation area where students can look at information?	YesNo
Are there facilities for video playback?	YesNo
Are there computing facilities with internet access for students to use?	YesNo
Please use this section to indicate what services you could provide to China
Projected student numbers for the academic year 2006/07 MBBS programs
Please indicate what major promotional activities you would undertake in order to achieve the above targets.