03/20/17 633
STATE OF NEVADA
DEPARTMENT OF BUSINESS AND INDUSTRY
REAL ESTATE DIVISION
3300 W. Sahara Ave., Suite 350, Las Vegas, Nevada 89102 * (702) 486-4033
e-mail: realest@red.nv.gov * http://red.nv.gov/
APPRAISER
INSTRUCTOR APPLICATION
1. Instructor Approval Requested for: Pre-License Instructor NAC 645C.230
Continuing Education NAC 645C.330
2. PROOF OF QUALIFICATIONS MUST BE ATTACHED. A full resume and applicable
Documents (licenses, certificates, etc.) must accompany all applications. Documents must clearly
Indicate how instructor is qualified to teach subject matter of course.
3. Name of Applicant: _______________________________________________________________________
Mailing Address: _______________________________________________________________________
Email Address: _______________________________________________________________________
Home Phone: ________________ Business Phone: ________________ Fax Number: ________________
4. Name and address of school or organization for which you will instruct:
_______________________________________________________________________________________
_______________________________________________________________________________________
5. Title of Course(s) which you will instruct:
________________________________________________________________________________________
________________________________________________________________________________________
U.S.P.A.P. INSTRUCTORS MUST BE CERTIFIED BY THE APPRAISER QUALIFICATIONS
BOARD (AQB) AND MUST ATTACH A COPY OF THEIR CERTIFICATION.
6. Have you ever been refused approval or a license to teach, or has such approval or license been
Suspended or revoked or subject to discipline? Yes No If yes, attach explanation
7. Have you ever been subject to disciplinary action by the Real Estate Commission or Commission
Of Appraisers? Yes No If yes, attach explanation.
8. I hereby affirm and swear that the information submitted with this application is true and accurate
And that no willful omissions have been made.
_____________________________________________ ____________________________________
Signature Date
INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED
_________________________________________________________________________________________
DIVISION USE ONLY
Date Application Approved: __________________________________Date of Notification: ________________________________
Approved By: _____________________________________________________________________________________________
