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Please complete the form below to register as a student. The information you provide must match the Florida Division of Real Estate's records. Please use capital letters where appropriate in your name and address.
Name
Mr. Mrs. Ms Miss Dr.
Title
First
Middle
Last
Street Address*
City*
State*
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Dakota North Carolina Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip Code*
This address is a*
Business Address Home Address
Use as billing address?*
Yes No
Work Phone
Extension
Home Phone
Fax
Cell
Email*
Social security number*
A license is required for CE and post-license exams. The Florida Division of Real Estate provides an online database for looking up license numbers.
Type
Number
Expiration
BK MB SL
January February March April May June July August September October November December ,
Required fields are marked with an asterisk (*).
