Real Estate Instructor Application For Original Approval


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PLEASE REVIEW THE APPROPRIATE RULE PRIOR TO COMPLETING THIS FORM
REAL ESTATE BROKERAGE AND/OR TEACHING EXPERIENCE

Select all that apply and attach information as required per Commission Rule 58H .0302(b) .
You must select at least 1 option.




REAL ESTATE BROKERAGE EXPERIENCE*
Provide details of all brokerage experience within the previous seven (7) years.
Employer #1
Dates of Employment

Employer #2
Dates of Employment

Employer #3
Dates of Employment

SECONDARY OR POST-SECONDARY-LEVEL TEACHING EXPERIENCE*
Provide details of all teaching experience at the high school or collegiate level within the previous seven (7) years.
Teaching Experience #1
Location of Institution
Dates you taught as an Instructor
Teaching Experience #2
Location of Institution
Dates you taught as an Instructor
APPROVAL AS A PRELICENSING OR POSTLICENSING INSTRUCTOR IN ANOTHER JURISDICTION*

Submit certification of such approval held within the previous seven (7) years.*
*Accepted File Types: .txt .pdf .docx .doc
*Max file upload size is 500KBs.

Total File Upload Size: 0.0*Kb

*The selected file exceeds the individual file upload limitations of 500KBs

CHARACTER

Provide a detailed written explanation in your own words describing the circumstances for each conviction/ pending charge. For a conviction, you must attach a copy of the court order of criminal record report showing disposition of the case. The Commission reserves the right to require the applicant to provide additional information, including a criminal record report from an agency acceptable to the Commission. *
*Accepted File Types: .txt .pdf .docx .doc
*Max file upload size is 500KBs.

Total File Upload Size: 0.000*Kb

*One or more selected files exceeds the individual file upload limitations of 500KBs

If “Yes”, Provide a detailed written explanation in your own words describing the circumstances for each disciplinary action and attach a copy of the licensing agency’s order (if the disciplinary agency was other than the NC Real Estate Commission). *
*Accepted File Types: .txt .pdf .docx .doc
*Max file upload size is 500KBs.

Total File Upload Size: 0.000*Kb

*One or more selected files exceeds the individual file upload limitations of 500KBs

OUT-OF-STATE REAL ESTATE LICENSE
Provide details regarding your out-of-state real estate license. Do not include NC real estate license history.
Jurisdiction #1
Dates you held a real estate license in this jurisdiction
Jurisdiction #2
Dates you held a real estate license in this jurisdiction
Jurisdiction #3
Dates you held a real estate license in this jurisdiction
COLLEGE EDUCATION
Provide the name and location of the institution you attended, your major, and the degree awarded.
Institution #1
Institution #2
Submit information that demonstrates your completion of at least 60 semester hours of college-level education, including: *
  • Name of institution that holds an accreditation that is recognized by the U.S. Department of Education
  • Location of institution (City, State)
  • Dates attended
  • Semester hours completed
Note: You may submit information from multiple institutions and areas of study, if necessary.

*Accepted File Types: .txt .pdf .docx .doc
*Max file upload size is 500KBs.

Total File Upload Size: 0.0*Kb

*The selected file exceeds the individual file upload limitations of 500KBs

NEW INSTRUCTOR SEMINAR
UPDATE INSTRUCTOR SEMINAR
Update instructors must attend the annual Update Instructor Seminar prior to teaching any Update courses. Your Update Instructor approval will be on INACTIVE status until you complete the seminar for the current year in which you plan to teach.


EMPLOYEE MISCLASSIFICATION
Read the Public Notice Statement. Click the box to certify that you have read the statement, and select Yes or No in response to the question regarding investigations. If you select Yes, you will be required to provide information regarding the case(s). If you have questions regarding this section, please direct them to the North Carolina Industrial Commission. Contact information is provided on the page.

As required by the NC state legislature in NCGS § 143-765, effective January 1, 2018, in order to apply for or renew an occupational license, permit, or certification, the applicant must certify that they have read and understand the public notice statement from the Employee Classification Section of the State Industrial Commission and must disclose any investigations for employee misclassification.

Public Notice Statement
required by N.C. Gen. Stat. § 143-764(a)(5), effective December 31,2017

Any worker who is defined as an employee by N.C. Gen. Stat. §§ 95-25.2(4)(NC Department Of Labor), 143-762(a)(3)(Employee Fair Classification Act), 96-1(b)(10)(Employment Security Act), 97-2(2)(Workers’ Compensation Act), or 105-163.1(4)(Withholding; Estimated Income Tax for Individuals) shall be treated as an employee unless the individual is an independent contractor. Any employee who believes that the employee has been misclassified as an independent contractor by the employee’s employer may report the suspected misclassification to the Employee Classification Section within the North Carolina Industrial Commission.

Employee Classification Section
North Carolina Industrial Commission
1233 Mail Service Center
Raleigh, NC 27699-1233
Telephone: (919) 807-2582
Fax: (919)715-0282
Email: emp.classification@ic.nc.gov

Employee misclassification is defined as avoiding tax liabilities and other obligations imposed by Chapter 95, 96, 97, 105, or 143 of the North Carolina General Statutes by misclassifying an employee as an independent contractor.N.C. Gen. Stat. § 143-762(5)




SIGNATURE AND CERTIFICATION OF APPLICANT

I certify that the information provided in this application is accurate to the best of my knowledge. I understand that any omission, inaccuracy, or failure to make full disclosure constitutes grounds for denial or withdrawal of approval to teach the Commission’s Prelicensing, Postlicensing, or Update courses and may constitute grounds for disciplinary action against me in connection with any other license or approval I hold that was issued by the N.C. Real Estate Commission.

(Type your name)

Date Signed

5/28/2020

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