Qualifying Real Estate Instructor Application Form - Texas Real Estate Commission
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2Texas Real Estate Commission
P.O. Box 12188
Austin, Texas 78711-2188
(512) 936-3000
Qualifying Real Estate Instructor Application
To be used for approval to teach Real Estate Qualifying and Non-Elective Continuing Education (CE) courses
App#
File#
FEE
RECEIPT NUMBER
AMOUNT
MONEY TYPE
Entity #
License #
Application Fee
$150.00
DO NOT WRITE ABOVE THIS LINE
1.Name
(Last)
(First)
(Middle)
2. Address
Address (Street Address)
(City)
(State)
(Zip Code)
3. Phone Number
4. Date of Birth
5. Email Address
6. If you have ever held a real estate license, complete the information below.
License Type
License Number
Areas of Specialization
State
Years Active
7. If you hold any other professional licenses, complete the information below.
License Type
License Number
Areas of Specialization
State
Years Active
8. Have you ever had a professional or occupational license in this state or any other state suspended,cancelled, or
revoked or ever surrendered such a license?
Yes
No
9.
Have you ever had an application for a professional or occupational license disapproved or denied in this state
or any other state?
Yes
No
10.
Are there any disciplinary hearings or investigations pending against any professional or occupational licenses
you hold?
Yes
No
11.
Are there any unpaid judgments pending against you?
Yes
No
12.
Have you ever been convicted of a criminal offense? (Include all felonies and misdemeanors other than minor
traffic tickets.)
Yes
No
Have you ever been placed on parole, probation or community supervision (also known as deferred
13.
adjudication) regardless of whether the case was dismissed or you were discharged?
Yes
No
14.
Are there any criminal charges pending against you?
Yes
No
If the answer is Yes to any of the questions in this section, the Background History Form is required.
This form is located on the TREC website at .
This document is available on the TREC website at
QE REI-0 (06/20/2016)
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