Adre Form Ed 103 PDF Details

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QuestionAnswer
Form NameAdre Form Ed 103
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesED-101, arizona department of real estate forms, educationazre, arizona real estate forms

Form Preview Example

Arizona Depart ment of Real Estate ( ADRE)

JANI CE K. BREW ER

GOVERNOR

Education Division

 

 

 

w w w .azre.gov

 

JUDY LOW E

education@azre.gov

 

COMMI SSI ONER

2910 N. 44t h STREET STE. 100

PHOENI X, AZ 85018

 

REQUEST FOR EXPEDITED INSTRUCTOR APPROVAL APPLICATION (ED-103)

To be used when an ADRE-approved school is seeking approval for an instructor who is currently an ADRE-approved instructor under a primary sponsoring school when an approved primary sponsoring school or secondary non-sponsoring school wishes to add approved courses to an approved instructors or to remove an instructor or instructor course approval from the primary sponsor school/secondary non-sponsor school. If not currently approved as an instructor under a primary sponsor school or not approved in the requested course category, do not use this form, use the ED-101.

CHANGE TYPE (Check all that apply):

Add Course(s)

Remove Course(s)

Add Secondary Non-Sponsor School

Remove Primary Sponsor School

Remove Secondary Non-Sponsor School

INSTRUCTOR INFORMATIONAND CERTIFICATION

Instructor's Name:

 

___

___________Approval No.:

_______ Expiration Date: ___________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address (if changed):

 

 

 

 

 

 

 

 

 

 

____

 

 

 

 

 

 

 

 

 

 

 

 

 

Include City, State & ZIP

 

 

 

Daytime Telephone:

 

 

 

Facsimile:

 

 

Email:

 

____

 

 

 

 

 

 

 

 

 

 

 

I am ADRE approved to teach the same course(s) for a Primary Sponsor School.

 

 

 

 

 

 

I am ADRE approved to teach similar courses on this category and/or subject area for my Primary Sponsor School.

 

 

 

Instructor Applicant Signature:

 

 

 

 

 

 

Date:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECONDARY NON-SPONSOR SCHOOL (The School for which the Instructor will teach, if applicable):

As the Secondary Non-Sponsor School Owner/Administrator, I have reviewed the instructor’s qualifications and credentials and hereby request the Department approve this Instructor to teach the courses specified in this application that are currently on file with ADRE for this School.

School’s Legal or DBA Name:

ADRE Approval Number:

 

 

 

Approval Exp. Date:

 

Owner/Administrator Name (Print /Signature):

 

 

 

Date:

 

 

 

School Approval Number:

 

 

 

Approval Exp. Date:

 

COURSE(S) THIS INSTRUCTOR WILL/WILL NO LONGER TEACH AT THE _______________________________:

 

 

 

(School’s Legal or DBA Name)

 

Approved Course Title

Category

Course No.

Expiration Date

Add

 

Remove

 

 

 

 

 

()

 

()

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Attach additional sheet if more space is needed.)

INSTRUCTOR’S PRIMARY SPONSORING SCHOOL AUTHORIZATION (Required for all Change Types listed above)

Sponsor School’s Legal or DBA Name:

ADRE Approval Number:

Approval Exp. Date:

Owner/Administrator Name (Print / Signature):

Date:

School Approval Number:

Approval Exp. Date:

Persons with disabilities who need this document in an alternative format should contact Business Services at 602-771-7766.

Request For Expedited Instructor Approval

Page 1 of 1

An Equal Employment Opportunity Agency

ED-103 Revised 12-6-2011

 

 

How to Edit Adre Form Ed 103 Online for Free

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Completing this document demands attentiveness. Make sure that every field is done accurately.

1. While submitting the INFORMATIONAND, be sure to complete all of the needed blank fields in their associated form section. It will help to speed up the work, making it possible for your information to be processed quickly and correctly.

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