Rev. 2/11/2013
Utah Division of Real Estate
CONTINUING EDUCATION
COURSE RENEWAL
Utah Division of
Real Estate
PO Box 146711
Salt Lake City,
UT 84114-6711
Title of Course
Name of Course Provider Provider No.
Coordinator/Director
Address Phone
City State Zip
This course is currently certified as number (#) for CE hours.
Traditional Classroom Online Course
This course has: (check one)
had no changes and may be renewed under the same conditions as it was previously
approved.
had the following minor, non-substantive changes:
Instructors certified to teach this course: Instructor License #:
A copy of the current course outline
Enclosed is the $75 renewal fee (for 2 years)
*
If renewing after expiration add $25 late fee.
*Do not teach course until you have received the renewal approval.
Course Coordinator/Director Signature Date
Office Use Only
Date Reviewed________By________
Approved
Denied
Certification Number______________
( ) Check ( ) Visa ( ) MasterCard ( ) American Express
Make checks payable to: Utah Division of Real Estate
Card # ____________________________________ Expires _________
Signature ___________________________________________________