Continuing Education Update Course Sponsor Application


An image of the North Carolin Real Estate Seal.


Applicant Details

Application Fee
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 10MBs total.

Total File Upload Size: 0.000*Mb

*Selected file(s) size exceed upload limitations of 10MBs

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 10MBs total.

Total File Upload Size: 0.000*Mb

*Selected file(s) size exceed upload limitations of 10MBs

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 10MBs total.

Total File Upload Size: 0.000*Mb

*Selected file(s) size exceed upload limitations of 10MBs

List the name(s) of your approved Update Course instructor(s). At least 1 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 10MBs total.

Total File Upload Size: 0.000*Mb

*Selected file(s) size exceed upload limitations of 10MBs


Signature and Certification

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.

I further certify 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.

I further certify that, 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.