Instructor Application - South Carolina Real Estate Commission (Page 2 of 2) in pdf

Instructor Application - South Carolina Real Estate Commission Page 2

IV. BACKGROUND/QUALIFICATIONS

1. I HAVE HAD THE FOLLOWING EDUCATION RELATED TO THE COURSE: __________________________________

___________________________________________________________________________________________________

I HAVE HAD THE FOLLOWING WORK EXPERIENCE RELATED TO THE COURSE(S) DURING THE LAST FIVE

YEARS:

Description of Experience

Affiliated with:

Year

(e.g. 2003-2007)

TEACHING EXPERIENCE: DURING THE LAST FIVE YEARS:

Note: We cannot consider your application for approval

unless this section filled out completely. Resumes cannot be used as a substitute for this information.

Course(s) Taught

Taught for

Number of

Year Taught

Hours Per

(e.g. 2003-2007)

Year

4. I HAVE THE FOLLOWING CURRENT TEACHING CERTIFICATE(S).

________________________________________________________________________________________________

V. ACKNOWLEDGEMENT

I hereby apply for approval as an instructor, and I attest to having qualities of honesty, integrity, and trustworthiness. I have

not had any real estate license or instructor approval revoked or suspended, nor have I received a reprimand or a fine from

any regulating entity of any state. I have not been convicted of, nor entered a plea of nolo contendere to, any criminal

offense involving moral turpitude. I have not had any civil judgment entered against me based on fraud, misrepresentation,

or deceit. (If you answer yes to any of the previous statements, please attach documentation giving complete details.)

I have read and agree to comply with the South Carolina Real Estate License and Certification Act and applicable regulations

of SCLLR – Real Estate Commission, Chapter 105.

Personal information provided in this application may be subject to public scrutiny or release under the South Carolina

Freedom of Information Act or other provisions of Federal and State law.

I have attained the authority from the provider to instruct the course(s) which I am applying to teach on this

application.

(Signed) ________________________________________

Date _________________________________

VI. ENCLOSURES

Application Fee of $100

Proof of degree in education (if applicable)

I HAVE ENCLOSED:

Resume

Current Teaching Certificate (if applicable)

Instructor Application - South Carolina Real Estate Commission Page 2