Register Your Agency
First Register Your Agency
After your agency has registered and been approved, you can revisit this website and login with the username and password you create below. Once you are logged in, you may begin the installation process. We will contact you once your agency has been approved.

AGENCY REGISTRATION FORM
 
If you have multiple branches please list only your central branch or head office's information.
 

Agency Information

Where Did You First Hear About AMS?*
:

Name of your Agency*
:

Year of Foundation :
     
Location Information
Country*
:
State
:
City*
:
 
 
Website Address*
:
example:  www.yoursite.com
Organization Memberships Held
:
     

Contact Person

Name*
:
 
Country  Area Phone
Phone Number*
:
Fax Number
:
      E-Mail and Password
Your e-mail address will also act as your username on AMS.
E-Mail*
:
Password*
:
(max. 15 characters)
Confirm  Password*
:
(max. 15 characters)
 
We ask that you submit a school reference so that we may be able to ensure the quality of our partners.
 

Reference School

School Name *
:
Contact Name*
:
E-Mail*
:
Phone*
:


Reference School 2

School Name *
:
Contact Name*
:
E-Mail*
:
Phone*
:


 
Notes
:
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Terms and Conditions

I Agree to the Terms and Conditions*
 
 
 



2007 AMS - Terms and Conditions