Rev. 04/09/2015
160 East 300 South, PO Box 146711, Salt Lake City, UT 84114-6711
Telephone (801) 530-6747 • Facsimile (801) 526-4387 • Internet: www.realestate.utah.gov
State of Utah
Department of Commerce
Division of Real Estate
APPRAISER QUALIFYING EDUCATION
C
OURSE APPLICATION
Complete and submit this form, the items listed below, and non-refundable fee of $70
to the Utah Division of Real Estate by fax, mail, or in person at the address listed on the bottom of this form.
**APPLICATIONS MUST BE SUBMITTED NOT LESS THAN 30 DAYS PRIOR TO THE DATE OF THE FIRST CLASS**
Credit Hours Requested: __________ (must be a minimum of 15 hours)
Course Title: _________________________________________________________________________________________________
Course Instruction Method: ( ) Traditional Classroom ( ) Distance Education (online)
Required Textbook Title: ________________________________ Author _____________________ Publisher ________________
**Course Date(s): ____________________________________________________________________________________________
Course Location: ____________________________________________________________________________________________
Owner/Director: ________________________________________________________________ Ph: __________________________
Company: _____________________________________________________________________ Fax: _________________________
Address: ______________________________________________________________________ Email: _______________________
Instructor: _______________________________________________ License #: ____________________ Expiration: ____________
Instructor: _______________________________________________ License #: ____________________ Expiration: ____________
Instructor: _______________________________________________ License #: ____________________ Expiration: ____________
( ) Instructor Application or copy of the Instructor Certification for each proposed course instructor.
( ) Copy of ALL course materials.
( ) Copy of the written policy and procedure for ensuring student attendance during class time.
( ) For Distance Education approval, submit instructions for accessing and reviewing the course.
( ) IDECC approval letter for all distance education courses.
( ) Course outline that provides a subject matter description for each 30 minute interval. (3-5 learning objectives for every 3 hours)
( ) Copies of at least 3 final examinations administered in the course with answer keys.
Provide learning objectives that indicate how the course will improve the licensee’s ability to protect and serve the public.
Licensee will be able to: _______________________________________________________________________________________
____________________________________________________________________________________________________________
Licensee will be able to: _______________________________________________________________________________________
____________________________________________________________________________________________________________
Licensee will be able to: _______________________________________________________________________________________
____________________________________________________________________________________________________________
Licensee will be able to: _______________________________________________________________________________________
____________________________________________________________________________________________________________
I have read and understand the administrative rules governing continuing education. I agree to allow the course to be audited on an
unannounced basis by the Division, to not market for a specific company, professional service, or personal sales products, and within 10
days of course completion, bank the hours each student has earned through the Division’s vendor.
Signature ___________________________________________________ Date ______________________________
( ) Check ( ) Visa ( ) MasterCard ( ) American Express
Make checks payable to: Utah Division of Real Estate
Card # ____________________________________ Expires __________
Signature _________________________________ CCV# ____________
OFFICE USE ONLY
Date Reviewed _______________ By _______
( ) Denied ( ) Approved
Certification _________________ Exp. ______
