Class Registration Form

Name:(As it appears on your license, if already licensed)

Company Name, if applicable:

License No. (If already licensed)

Home Phone:
Business Phone:
Cell Phone:
Fax:


Home Address:

City:

State:

Zip:

Email Address:

I wish to enroll in: (Need Help? Check Course Descriptions)

Check all that apply:

Principles of Real Estate- Salesperson (30 hours)

Class Location: (Check Schedule)

Class Date: (Check Schedule)

Class Time: (Check Schedule)

Principles of Real Estate - Broker (24 hours)

Class Location: (Check Schedule)

Class Date: (Check Schedule)

Class Time: (Check Schedule)

Required Salespersons Post License (30 hours)

Class Location: (Check Schedule)

Class Date: (Check Schedule)

Class Time: (Check Schedule)

Contracts ( Broker & Sales Elective)

Class Location: (Check Schedule)

Class Date: (Check Schedule)

Class Time: (Check Schedule)

Mandatory Sales & Broker Core

Class Location: (Check Schedule)

Class Date: (Check Schedule)

Class Time: (Check Schedule)

Business Management (Broker Core/Sales Elective)

Class Location: (Check Schedule)

Class Date: (Check Schedule)

Class Time: (Check Schedule)

 

Payment Method:

*If paying by mail, please print a copy of this form to send with your check before submitting your application.

Success Real Estate Institute
One East Ninth Ave.
Hutchinson, KS 67501
(620) 662-6441
(620) 694-6627