COMMISSION USE ONLY
Receipt # ______________
Date Paid ______________
ARKANSAS REAL ESTATE COMMISSION
Phone: (501) 683-8010 Fax: (501) 683-8020
REAL ESTATE INSTRUCTOR LICENSE
RENEWAL FORM
AREC 1/2020
Return to: Arkansas Real Estate Commission | 612 South Summit St | Little Rock, AR 72201
Principal Instructor’s License $150 $400
FEES: If paid before/on March 31, 2020: aer March 31, 2020:
Associate Instructor’s License $100 $350
Licensee’s Name (Printed) : ______________________________________________________________
Licensee’s Signature: ___________________________________________ Date: __________________
(First Name) (Middle Name) (Last Name)
School Name: _______________________________________ School Phone: ___________________
Instructor Type: Principal Associate
Address: ____________________________________________ PO Box: ____________
Fax: ________________________________ Email address: _______________________________
Home Address: ____________________________________________ PO Box: ____________
Personal Phone: _______________________ Email address: __________________________________
City: __________________________________ State: __________ Zip: _____________
City: __________________________________ State: __________ Zip: _____________
SCHOOL INFORMATION:
Have you been convicted of or plead guilty or nolo contendere to any crime other than a trac violation that
you have not reported to AREC as required by Regulation 10.16? YES NO
(If you answered “YES”, please furnish documentation as required by Commission Regulation 10.16(a)).
As Principal Instructor, I hereby authorize issuance of an instructor’s license with the above school.
Main School
Branch School
Instructor License Number: _________________________
Renewals will not be accepted aer April 30, 2020
Instructor License Number: _________________________
Principal Instructor Name (Please Print)
Principal Instructor Signature Date
_______________________________________
________________________________________________________
