Student Name *

(to appear on certificate)

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Application Date *

MM

DD

YYYY

Course Beginning on: *

MM

DD

YYYY

I UNDERSTAND THAT: (1) Meals, lodging, writing instruments, and calculators are not included or furnished; (2) no recording device may be used in classroom sessions; and (3) smoking is not permitted during class sessions inside the building. *

I AGREE

I FURTHER UNDERSTAND THAT: (1) I must attend all sessions and pass a written comprehensive examination given by the Institute in order to receive a Certificate of completion of a course; (2) the number of attendance hours and final exam grade will be reported to the Louisiana Real Estate Commission, to which I consent; and (3) a high school diploma or a Certificate of Equivalency is required in order to apply for a real estate license in the State of Louisiana.  The Institute may delay issuance of a Certificate until payment is made in full. *

I AGREE

I FURTHER UNDERSTAND AND AGREE TO the following policies regarding tuition, refund and guarantee:  At least part of the tuition is payable in advance with enrollment as set out below.  If I am unable to begin the course I will be charged $100.00 for administrative processing costs and for reserving a space in the class.  PROVIDED WRITTEN NOTICE has been received at least (7) days prior to the initial scheduled session and provided all work manuals and materials handed me have been returned in their original condition.  The balance of the tuition paid will be refunded or applied to a subsequent class as requested.  Full refund will be made if no space is available in the class, or if the class is cancelled.  NO REFUND WILL BE GIVEN AFTER BEGINNING DATE.  FULL PAYMENT OF TUITION MUST BE MADE EVEN THOUGH I DO NOT COMPLETE THE COURSE.  If I hold a Certificate of Completion of Real Estate 101, but take and fail the state license examination within 1 calendar month after successful completion of the course, I may within (8) months after certification repeat RE101 without tuition charge.  Failure to complete any course within a period of (1) year from beginning date will require repeating the course at the then-current tuition charge. *

I AGREE

I FURTHER UNDERSTAND the Institute shall have the right to discontinue instruction and to cancel my enrollment at any time for violation of Institute rules or unsatisfactory advancement.  My enrollment may be rejected because of space limitation; and any class may be cancelled for any reason. *

I AGREE

I FURTHER UNDERSTAND it is necessary for all applicants having any type of criminal conviction, felony or misdemeanor, to undergo a limited background investigation and to obtain Louisiana Real Estate Commission authorization before they can take the licensing examination, and that if I have any kind of criminal history, it would be prudent for me to contact the Commission's Investigative Division prior to enrolling in any pre-licensing course. *

I AGREE