Fillable EDUCATION INDIVIDUAL REQUEST FORM | RE-800 (Kansas Real Estate Commission)

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EDUCATION INDIVIDUAL REQUEST FORM | RE-800 (Kansas Real Estate Commission)

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Kansas Real Estate Commission
Jayhawk Tower
700 SW Jackson St Ste 404
Topeka, KS 66603-3785
krec@ks.gov (785) 296-3411
Fax: (785) 296-1771 www.krec.ks.gov
Public access is available by appointment only
EDUCATION INDIVIDUAL REQUEST FORM | RE-800
Page 1 of 2
Revised Oct-20
INSTRUCTIONS This is a fillable form
Complete this form to request up to nine elective CE credit hours for real estate-related courses not listed in the Directory of Approved
Continuing Education Providers and Courses.
• Licensees are limited to a single three-hour appraisal-type course per renewal period
• If denied, you must complete another course prior to your license expiration date. Check CE at: licensing.ks.gov/EGOV_KREC.
REQUIRED DOCUMENTATION
The following materials must be included for each course and sent electronically to kreceducation@ks.gov:
Course outline
Course completion certificate signed by the course sponsor or instructor
Proof of passing score of 90% or better on the exam or quiz questions for distance education courses
FEES
$10.00 per course - Enclose attached credit card payment form
LICENSEE INFORMATION:
L
ICENSEE
N
AME
L
ICENSE
N
UMBER
COURSE AND PROVIDER INFORMATION:
C
OURSE
T
ITLE
S
CHOOL
N
AME
D
ATE OF
C
OMPLETION
WITHIN CURRENT RENEWAL PERIOD ONLY
SCHOOL EMAIL
NON-RESIDENTS:
IS
THIS
COURSE
APPROVED
IN
YOUR
STATE
OF
RESIDENCE?
□ YES, AND I’VE INCLUDED PROOF
COURSE AND PROVIDER INFORMATION:
COURSE TITLE
SCHOOL NAME
D
ATE OF
C
OMPLETION
WITHIN CURRENT RENEWAL PERIOD ONLY
S
CHOOL
E
MAIL
NON-RESIDENTS: IS THIS COURSE APPROVED IN YOUR STATE OF RESIDENCE? □ YES, AND I’VE INCLUDED PROOF
COURSE AND PROVIDER INFORMATION:
C
OURSE
T
ITLE
S
CHOOL
N
AME
DATE OF COMPLETION
WITHIN CURRENT RENEWAL PERIOD ONLY
S
CHOOL
E
MAIL
NON-RESIDENTS:
IS
THIS
COURSE
APPROVED
IN
YOUR
STATE
OF
RESIDENCE?
□ YES, AND I’VE INCLUDED PROOF
LICENSEE SIGNATURE
SIGNATURE DATE SIGNED
click to sign
signature
click to edit
Kansas Real Estate Commission
Jayhawk Tower
700 SW Jackson St Ste 404
Topeka, KS 66603-3785
krec@ks.gov (785) 296-3411
Fax: (785) 296-1771 www.krec.ks.gov
Public access is available by appointment only
EDUCATION INDIVIDUAL REQUEST FORM | RE-800
Page 2 of 2
Revised Oct-20
Option1: CREDIT CARD PAYMENT INFORMATION
Card Holder Name:
Email Address:
(for electronic receipt)
Card Number:
Card Expiration Date:
Option 2: ELECTRONIC CHECK PAYMENT INFORMATION
Account Holder Name:
Email Address:
(optional for electronic receipt)
Transaction Type:
Personal
Business
Account Type:
Checking
Savings
Check Number:
Account Number:
Routing Number:
Submit to the Kansas Real Estate Commission by:
Email: kreceducation@ks.gov
Fax: 785-296-1771
After processing your payment, this document will be shredded.
If you prefer to provide your credit card information by phone, call 785-296-3411.
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EDUCATION INDIVIDUAL REQUEST FORM RE-800 (Kansas Real Estate Commission)

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Completed 28 December 2021

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