Real Estate Application - Real Estate Career & Development Center

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Real Estate Application
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Real Estate Career & Developement Center

Real Estate Application for Licensure

To reserve a seat in our next session, please complete the following application. Ensure the following information is accurate. Falsification of any information on this real estate application will result in the loss of license by the Georgia Real Estate Commission. Once your application has been processed and the course begins, you will sign this application and present a valid Georgia picture ID. This application will remain as part of your student record in our school. You must also REGISTER for the class by clicking on the "In-House" Registration Payment tab.

Applicant Information:

* Indicates required field

Social Security Number (No dashes) *

Last Name *

First Name *

Middle Name or Initial *

Residence Address:

Street Number, Street Name, Apartment / Unit # *

City, State and Zip Code *

Mailing Address:

Street Number, Street Name Apartment . Unit # *

City State Zip Code *

Choose One *

Female Male

Birthdate (Month / Day / Year) *

eMail: *

Are you applying for a license as a Georgia resident? *

Yes No

Are you a Veteran who served at least 90 days active duty during war time? *

Yes No

Have you ever been licensed as a salesperson or broker in another state? If yes, bring a Certificate of History from each state, no older than one year, with you to the testing center *

Yes No

If you answered YES,what state? *

If YES, under what name? *

Have you ever held or do you hold a real esate license in Georgia? *

Yes No

License # *

If YES, under what name? *

Are you a high school graduate or hold a General Education Certificate (GED)? If your answer to this question is NO, bring proof of educational equivalency to the testing center with you. *

Yes No

Have you ever been convicted of, Pled Nolo Contendere or been granted first offender treatment upon being charged with (1) any criminal offense other than a traffic violation or (2) any violation that involved driving under the influence of alchol or drugs, homocide, or feticide by vehicle , fleeing the scene of an accident, attempting to elude an officer or impersonating an officer? *

Yes No

Have you ever been disciplined by the Georgia Real Estate Commission or any other State or Federal Licensing Agencyor authority which regulates any profession? *

Yes No

Are there any criminal charges or licensing disciplinary proceedings pending against you at this time? *

Yes No

Are you currently required by any court, administrative or contempt order to make child support? *

Yes No

If applying for a Brokers license, how many years have you been actively licensed as Salesperson? *

If applying for a Broker's License, how many years have you been actively licensed as Broker? *

If applying for a Broker's License, how many years have you bee n actively licensed as a Community Asociation Manager? *

Submit

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