Form 36071 - Application For Approval Of Real Estate Salesperson / Broker'S Course - Indiana Real Estate Commission Page 4

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I (we) the undersigned, submit this application in conformance with Section 12, Article 34 of the Indiana Code and the Rules and
Regulations of the Indiana Real Estate Commission pertaining thereto for permission and authority to provide the heretofore de-
scribed courses of instruction at the location specified. I (we) understand that any violation of the License Law or Rules and
Regulations on my (our) part will subject me (us) to loss of approval.
I (we) further certify that to the best of my (our) knowledge, the information given in this application is true and correct.
Signature of Director
Signature of principal instructor
STATE OF INDIANA
SS:
COUNTY OF _________________________________
Subscribed and sworn to before me this __________ day of _______________________________________, ________.
Signature of Notary
County of residence
Typed or printed name of Notary
Date Commission expires
FOR OFFICE USE ONLY
SUMMARY OF DOCUMENTS TO BE ATTACHED
BEFORE RETURNING THIS COMPLETED FORM
Date of approval (mo., day, yr.)
Approval granted by Indiana
Real Estate Commission.
Signature of approving authority
1. A copy of the certificate of incorporation. (if applicable)
2. A certificate of good standing of the Corporation issued
Title
by the Secretary of the State of Indiana. (if applicable)
Remarks
3. Proof of Surety Bonding in the amouny of $10,000.
(See Section "Proof of Surety Bond" on page 2)
4. Copy of Accreditation certificate. (if applicable)
5. Resume of course Director.
6. Resume of principal instructor
7. Resume of additional instructors
8. List of additional instructors and their resumes. (if
applicable)
9. Proposed school grading policy and rules of operation.
10. Sample of proposed certificate to be issued to passing
students.
11. Complete teaching syllabus. (if additional syllabus will
be used)
12. Keyed copies of all written examinations.
13. Detailed proposed refund policy and schedule of fees to
students.
RETURN TO:
Indiana Real Estate Commission
302 West Washington Street, Room E034
Indianapolis, IN 46204

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