Course Registration Form

Broker Course Application

Fill out the form carefully for review. After review of your application, If accepted for the class, a registration link will be sent to your email.
Student Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail
example@example.com
Cell Number
Format: (000) 000-0000.
Work Number
Format: (000) 000-0000.
Have you every been convicted of or entered a plea of guilty or nolo contendere (no contest) to any felony, misdemeanor or other criminal offense, including any offense for which you have received a pardon, in any jurisdiction?
Are any criminal charges pending against you?
Do you have any impairment related to drugs or alcohol that would limit your ability to undertake the practice of real estate in a manner consistent with the safety of the public?
Are you actively licensed as a real estate agent in Delaware (or an agent/broker in a different jurisdiction) and have been for at least five continuous years prior to your application?
Have three of the five previous years been spent actively practicing real estate (i.e., representing buyers or sellers in a transaction)?
Do you have documentation of at least 30 sales or lease transactions that you completed during the five years immediately prior to yur application? (NOTE: timeshare or property management transactions DO NOT satisfy this requirement.)
I certify that the information in this application is complete and true. I understand that the intentional inclusion of false or fraudulent information may result in dismissal from the class. Please sign below.
Signature
Should be Empty:

Broker Course Application