Continuing Education Elective Course Sponsor Application


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Applicant Details

Application Fees
By selecting YES, you are confirming that you are a government agency or a community college, junior college, college or university located in North Carolina and accredited by the Southern Association of Colleges and Schools and exempt from any application fees. Selecting this option in error will result in your application being denied and you will need to reapply.

Entity Details
Type of entity [Indicate the applicant's legal form of business. Check all that apply.]*











*[NOTE: If applicant is a corporation, limited liability company (LLC), or limited partnership, the applicant must provide the SOSID. A corporation, LLC or limited partnership is required by North Carolina law to be registered with the office of the N.C. Secretary of State and to maintain that registration on current status. Applicants must be in compliance with these requirements to be eligible for approval and compliance will be verified by the Commission."]

Ownership/Management Information
CORPORATION
Corporate Officers. List below the names, corporate titles and percentage of stock ownership of all the major officers (President, Vice-President(s), Secretary, Treasurer, etc.) of the corporation. [Attach additional sheet(s) if necessary.] Provide the requested information in the appropriate box below. If you need to add more officers you can attach a file in the Additional Details section at the end of this form.
Corporate Officer #1
Corporate Officer #2
Corporate Officer #3
Corporate Officer #4
Other Corporate Shareholders
List below any additional persons/entities owning at least 10% of the outstanding shares of stock of any class. Also list the percentage owned.
Corporate Shareholder #1
Corporate Shareholder #2
Corporate Shareholder #3
Corporate Shareholder #4

LIMITED LIABILITY COMPANY
Managers and Members. List below the name and mailing address of each manager, as well as the name an address of each member with an ownership interest of at least 10%. Select "Manager" or "Member" for each person listed and show percentage of ownership interest. If you need to add more managers or members you can attach a file in the Additional Details section at the end of this form.
Manager/Member #1
Manager/Member #2
Manager/Member #3
PARTNERSHIP OR OTHER BUSINESS ENTITY
List below the name, mailing address and title of any person/entity who serves as a major officer or manager of the business entity, as well as the name and mailing address of any person who has an ownership interest of at least 10%. If you need to add more partners or principles you can attach a file in the Additional Details section at the end of this form.
Principle #1
Principle #2
Partners
Partner #1
Partner #2

Additional Details

If "Yes" attach a copy of the court judgment, release from parole or probation, and a complete explanation from each affected person providing full details. *
*Accepted File Types: .tiff .tif .jpeg .jpg .txt .pdf .docx .doc .png
*Max file upload size 20MBs total.

Total File Upload Size: 0.000*Mb

*Selected file(s) size exceed upload limitations of 20MBs

If "Yes" attach a copy of the licensing agency's order and a complete explanation for each affected person providing full details. *
*Accepted File Types: .tiff .tif .jpeg .jpg .txt .pdf .docx .doc .png
*Max file upload size 20MBs total.

Total File Upload Size: 0.000*Mb

*Selected file(s) size exceed upload limitations of 20MBs

An applicant with an out-of-state business address (or residence address if a sole proprietor with no separate place of business) must submit a completed "Consent to Service of Process and Pleadings" form (REC 1.03) *
*Accepted File Types: .tiff .tif .jpeg .jpg .txt .pdf .docx .doc .png
*Max file upload size 20MBs total.

Total File Upload Size: 0.000*Mb

*Selected file(s) size exceed upload limitations of 20MBs


Elective Courses Information

Attach evidence of permission from the course owner to seek Commission approval of this course*
*Accepted File Types: .tiff .tif .jpeg .jpg .txt .pdf .docx .doc .png
*Total max file upload of all selected files combined in this webform is 20Mbs.

Total File Upload Size: 0.000*Mb

*Selected file(s) size exceed upload limitations of 20MBs

Please select the statement that best describes this course.*

This course has not been previously approved.

This course has already received Commission approval and will be conducted exactly as it was submitted for original approval.

This course uses materials from a course that has already received Commission approval, but will differ in some way from the approved course.

Attach evidence of permission from the course owner to seek Commission approval of this course*
*Accepted File Types: .tiff .tif .jpeg .jpg .txt .pdf .docx .doc .png
*Total max file upload of all selected files combined in this webform is 20Mbs.

Total File Upload Size: 0.000*Mb

*Selected file(s) size exceed upload limitations of 20MBs

Provide credentials of instructor(s) to be used by this sponsor if different from instructor(s) used by the Primary Sponsor, and provide information relating to technical support if different from support specified by Primary Sponsor.
*Accepted File Types: .tiff .tif .jpeg .jpg .txt .pdf .docx .doc .png
*Total max file upload of all selected files combined in this webform is 20Mbs.

Total File Upload Size: 0.000*Mb

*Selected file(s) size exceed upload limitations of 20MBs

Attach the instructor guide.*
  • The instructor guide should give a detailed course outline including the amount of time to be devoted to each major topic and to breaks, and the leaning objective(s) for each major topic: and
  • the instructional methods and instructional aids that will be utilized in the course
*Accepted File Types: .tiff .tif .jpeg .jpg .txt .pdf .docx .doc .png
*Total max file upload of all selected files combined in this webform is 20Mbs.

Total File Upload Size: 0.000*Mb

*Selected file(s) size exceed upload limitations of 20MBs

Attach the student manual.*
  • The student manual must provide, in narrative or text form, all pertinent details of the information to be presented in the course
*Accepted File Types: .tiff .tif .jpeg .jpg .txt .pdf .docx .doc .png
*Total max file upload of all selected files combined in this webform is 20Mbs.

Total File Upload Size: 0.000*Mb

*Selected file(s) size exceed upload limitations of 20MBs

Attach a document specifying information as to how this course meets the interactivity standards.*
*Accepted File Types: .tiff .tif .jpeg .jpg .txt .pdf .docx .doc .png
*Total max file upload of all selected files combined in this webform is 20Mbs.

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Attach a document specifying information as to how student mastery is assured.*
*Accepted File Types: .tiff .tif .jpeg .jpg .txt .pdf .docx .doc .png
*Total max file upload of all selected files combined in this webform is 20Mbs.

Total File Upload Size: 0.000*Mb

*Selected file(s) size exceed upload limitations of 20MBs

Attach the time studies/field tests to support classroom equivalency hours.*
*Accepted File Types: .tiff .tif .jpeg .jpg .txt .pdf .docx .doc .png
*Total max file upload of all selected files combined in this webform is 20Mbs.

Total File Upload Size: 0.000*Mb

*Selected file(s) size exceed upload limitations of 20MBs

Attach a copy of course materials (CD-ROM, disks, Internet access, etc.)*
*Accepted File Types: .tiff .tif .jpeg .jpg .txt .pdf .docx .doc .png
*Total max file upload of all selected files combined in this webform is 20Mbs.

Total File Upload Size: 0.000*Mb

*Selected file(s) size exceed upload limitations of 20MBs

Attach a copy of the course developer(s) credentials.*
*Accepted File Types: .tiff .tif .jpeg .jpg .txt .pdf .docx .doc .png
*Total max file upload of all selected files combined in this webform is 20Mbs.

Total File Upload Size: 0.000*Mb

*Selected file(s) size exceed upload limitations of 20MBs

Attach a copy of the Instructor's credentials and specific training related to the delivery method for which the approval is requested.*
*Accepted File Types: .tiff .tif .jpeg .jpg .txt .pdf .docx .doc .png
*Total max file upload of all selected files combined in this webform is 20Mbs.

Total File Upload Size: 0.000*Mb

*Selected file(s) size exceed upload limitations of 20MBs

Attach a copy of the Student Orientation Package*
*Accepted File Types: .tiff .tif .jpeg .jpg .txt .pdf .docx .doc .png
*Total max file upload of all selected files combined in this webform is 20Mbs.

Total File Upload Size: 0.000*Mb

*Selected file(s) size exceed upload limitations of 20MBs

Attach a copy of the ARELLO Summary Sheet*
*Accepted File Types: .tiff .tif .jpeg .jpg .txt .pdf .docx .doc .png
*Total max file upload of all selected files combined in this webform is 20Mbs.

Total File Upload Size: 0.000*Mb

*Selected file(s) size exceed upload limitations of 20MBs

List below the name(s) of all prospective instructors for the course. At least one prospective instructor name is required.

Additional Documentation

Attach additional documentation that you feel is necessary to support your request.
*Accepted File Types: .tiff .tif .jpeg .jpg .txt .pdf .docx .doc .png
*Max file upload size 20MBs total.

Total File Upload Size: 0.000*Mb

*Selected file(s) size exceed upload limitations of 20MBs


Signature and Certification

[If the course sponsor applicant has not been previously approved by the Commission or if previous approval has expired, this application must be signed by the owner (if a sole proprietorship), a managing partner (if a partnership), or a major officer authorized to submit such application (for other types of business entities). If applicant is an accredited community college, college/university or junior college, the application must be signed by the vice-president or dean responsible for the institution's continuing education program (or by the institution's president). If the applicant is a currently approved elective course sponsor, this application may be signed by the applicant's Continuing Education Coordinator or by the persons indicated above].

I hereby certify that all information submitted in connection with this application is true and accurate to the best of my knowledge and belief. I understand that any omission or inaccuracy may be grounds for denial of approval of the course, and that the applicant and all persons in its employ will fully comply with the requirements of the North Carolina Real Estate Commission regarding the conduct of continuing education courses, except for obtaining approval of the North Carolina Real Estate Commission to conduct real estate continuing education courses, the applicant has complied with all legal requirements to engage in business in North Carolina.

(Type your name)

Date Signed

12/18/2017


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107.20.115.174

This form is not meant to be printed. If you have already completed the form please use the submit button at the bottom to send the form directly to the Commission.