STATE OF NEVADA
DEPARTMENT OF BUSINESS AND INDUSTRY – REAL ESTATE DIVISION
COMMON-INTEREST COMMUNITIES AND CONDOMINIUM HOTELS
02/20/2018 Page 1 of 1 Form 670
3300 W. Sahara Ave., Suite 350, Las Vegas, Nevada 89102 • (702) 486-4033 • CAMEducation@red.nv.gov
CIC EDUCATION INSTRUCTOR APPLICATION
PRE-CERTIFICATION CONTINUING EDUCATION
Applicant’s E-Mail Address:
2. Name and address of School/Organization/Sponsor for which the applicant will instruct:
4. Proof of Qualification MUST be attached to include:
Detailed resume defining dates (from-to) of schooling and experience. Describe experience in the field in which
applicant is applying to instruct so that resume, not bio clearly shows how applicant is qualified to teach subject
matter of course per NAC 116A.270.
Copies of applicable documents (professional licenses, certificates, etc.).
QUESTIONS 5, 6, AND 7 MUST BE ANSWERED BY APPLICANT:
5. Have you ever been refused approval of a license or certificate by any Federal, State, County or City agency?
Yes No If yes, attach an explanation.
6. Has any license or certificate held by you been suspended, revoked or subject to discipline?
Yes No If yes, attach an explanation.
7. Have you ever been subject to disciplinary action by any Federal, State, County or City agency?
Yes No If yes, attach an explanation.
INCOMPLETE SUBMISSION WILL RESULT IN DELAY OF APPLICATION
I declare under penalty of perjury under laws of the State of Nevada that the foregoing and attached documentation and statements of
experience and eligibility are true and correct. If approved, I agree to comply with all applicable laws, regulations, policies and
procedures, including the Instructor Responsibilities (NAC 116A.275
) which I have read and understood and will duly execute upon
the grant of this application.
(Signature of Instructor)
(Print Instructor’s Name)
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FOR NRED INTERNAL USE ONLY
*Individual instructor application is required for each instructor. Mail or email to CAMEducation@red.nv.gov
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